Does Off-pump Coronary Revascularization Reduce the Release of the Cerebral Markers, S-100β and NSE? - 16/08/11
, Edvin Prifti, MD b, Massimo Maiani, MD a, Fabio Bartolozzi, MD c, Marco Di Eusanio, MD d, Marzia Leacche, MD b
Corresponding author at: Divisione di Cardiochirurgia, Policlinico di Careggi, Viale Morgagni, 85, 50134 Careggi Firenze, Italy. Tel.: +39 338 9855 782; fax: +39 05 5794 7458.Résumé |
Objectives |
The aims of this study were to (1) compare the release of S-100β and NSE in off-pump coronary artery bypass grafting (CABG) versus on-pump surgery; (2) investigate whether the S-100β and NSE serum concentrations correlate with cardiopulmonary bypass (CPB) duration.
Materials and methods |
Between October 2002 and May 2004, 42 patients undergoing first time CABG surgery were enrolled in the study. The exclusion criteria were: LVEF<35%, age>70 years, previous myocardial infarction, REDO surgery, the presence of valvular heart disease and/or cerebrovascular disease, abnormal preoperative carotid vessels angiography, coronary artery disease involving the distal circumflex artery, renal dysfunction, coagulopathy. The patients were randomly assigned either to undergo on-pump CABG surgery [group I, n=24 patients] or off-pump CABG [group II, n=18 patients]. Blood was not re-transfused from the cardiotomy suction. All patients presenting haemolysis were excluded from the study.
Results |
The preoperative S-100β was 0.13±0.08 (μg/l) and NSE 7±1.5 (μg/l) in group I and 0.12±0.1 (μg/l) and 6.9±2.7 (μg/l), respectively in group II. Six hours after the surgery, S-100β in patients of group I reached a maximum level of 1.38±0.4 (μg/l) and NSE of 17.7±6.5 (μg/l) compared to 0.5±0.11 (μg/l) [S-100B] and NSE 8.6±4.2 (μg/l) in group II (p=0.001). Three (12%) patients in group I and none (0%) in group II suffered postoperative delirium, p=0.247. No strokes occurred linear regression analysis revealed a strong correlation between cardiopulmonary bypass duration and S-100β and NSE peak levels, p<0.0021 (r2=0.36) and p<0.0001 (r=0.81), respectively.
Conclusion |
Coronary artery bypass surgery with CPB causes a significantly greater increase in NSE and S-100β serum levels than off-pump surgery and correlates with CPB duration.
Le texte complet de cet article est disponible en PDF.Keywords : Off-pump coronary revascularization, Brain impairment, Neurone-specific enolase, S-100B protein
Plan
Vol 15 - N° 5
P. 314-319 - octobre 2006 Retour au numéro
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