Abstract
This prospective non-randomized clinical study was done to compare Off-pump and On-pump myocardial revascularization by Troponin I release in patients undergoing first elective coronary artery bypass graft used to evaluate myocardial injury. One hundred an twenty patients were non-randomly assigned to a Off-pump or On-pump myocardial revascularization group. Cardiac Troponin I (CTnI) were measured in serial venous blood samples drawn preoperatively in both groups. In On-pump group after aortic unclamping at 12 and 24 hours and in Off-pump group after the last distal anastomosis at 12 and 24 hours. The total amount of CTnI release were significantly higher in On-pump group than in Off-pump group. In On-pump group it was 2.1 +/- 1.9 (mean +/- SD) ng/ml vs in Off-pump group it was 1.0 +/- 1.7 (mean +/- SD) ng/ml at 12 hours and in On-pump group it was 1.6 +/- 1.6 (mean +/- SD) ng/ml vs. in Off-pump group it was .9 +/- 1.6 (mean +/- SD) ng/ml at 24 hours (P < 0.0001 for the pattern). The lower release of CTnI in the Off-pump myocardial revascularization group indicates that the arrested heart coronary revascularization group causes more damage to the heart due to cardiopulmonary bypass than Off-pump myocardial revascularization group.
Highlights
Atherosclerotic coronary artery disease (CAD) is the most common cause of death in western world
The aim of this prospective randomized study was to evaluate the myocardial protection in Off-pump coronary artery bypass grafting (CABG) group by the estimation of Cardiac Troponin I (CTnI) release and to compare between Off-pump and On-pump CABG group and their short-term in-hospital outcome
The number of patients suffering from Diabetes Mellitus (DM), atrial fibrillation (AF) and LBBB/ RBBB did not differ markedly between the groups
Summary
Atherosclerotic coronary artery disease (CAD) is the most common cause of death in western world. It has been suggested that CTnI specificity to detect myocardial injury may be greater than that of Cardiac troponin T (CTnT)[6] The aim of this prospective randomized study was to evaluate the myocardial protection in Off-pump CABG group by the estimation of CTnI release and to compare between Off-pump and On-pump CABG group and their short-term in-hospital outcome. This prospective non-randomized clinical study was done to compare Off-pump and Onpump myocardial revascularization by Troponin I release in patients undergoing first elective coronary artery bypass graft used to evaluate myocardial injury. Conclusion: The lower release of CTnI in the Off-pump myocardial revascularization group indicates that the arrested heart coronary revascularization group causes more damage to the heart due to cardiopulmonary bypass than Off-pump myocardial revascularization group
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