Abstract
BackgroundWe aimed to evaluate serum levels of S-100 beta (S-100β) and neuron specific enolase (NSE) in patients with coronary heart disease (CHD) after off-pump versus on-pump coronary artery bypass graft (CABG) surgery.MethodsThe PubMed (~2013) and the Chinese Biomedical Database (CBM) (1982 ~ 2013) were searched without language restrictions. After extraction of relevant data from selected studies, meta-analyses were conducted using STATA software (Version 12.0, Stata Corporation, College Station, Texas USA). Possible sources of heterogeneity were examined through univariate and multivariate meta-regression analyses and verified by Monte Carlo Simulation.ResultsEleven studies with a total of 411 CHD patients met the inclusion criteria. Our meta-analysis showed no significant difference in serum S-100β and NSE levels between the on-pump group and the off-pump group before surgery. In the on-pump group, there was a significant difference in serum S-100β levels of CHD patients between before and after surgery, especially within the first 24 h after surgery. Furthermore, in the on-pump group, there was a significant difference in serum NSE levels of CHD patients between before and after surgery, particularly at 0 h after surgery. In the off-pump group, there was an obvious difference in serum S-100β levels between before and after surgery, especially within 24 h after surgery. Our results also demonstrated that serum S-100β and NSE levels of CHD patients in the on-pump group were significantly higher than those of patients in the off-pump group, especially within 24 h after surgery.ConclusionsOur findings provide empirical evidence that off-pump and on-pump CABG surgeries may increase serum S-100β and NSE levels in CHD patients, which was most prominent within 24 h after on-pump CABG surgery.
Highlights
We aimed to evaluate serum levels of S-100 beta (S-100β) and neuron specific enolase (NSE) in patients with coronary heart disease (CHD) after off-pump versus on-pump coronary artery bypass graft (CABG) surgery
Quantitative data synthesis Our meta-analysis showed no significant difference in serum S-100β and NSE levels between the on-pump group and the off-pump group before surgery (S100β: Standardized mean difference (SMD) = 0.14, 95 % Confidence intervals (CI) = −0.07 ~ 0.35, P = 0.191; NSE: SMD = −0.12, 95 % CI = −0.42 ~ 0.17, P = 0.408; respectively) (Fig. 1)
In the on-pump group, there was a significant difference in serum S-100β levels of CHD patients between before and after surgery (SMD = 2.05, 95 % CI = 1.55 ~ 2.55, P < 0.001), especially within 24 h after surgery (0 h: SMD = 4.81, 95 % CI = 3.20 ~ 6.41, P < 0.001; 6 h: SMD = 2.41, 95 % CI = 1.26 ~ 3.55, P < 0.001; 24 h: SMD = 1.14, 95 % CI = 0.66 ~ 1.62, P < 0.001), while no such difference was found after 24 h post-surgery (48 h: SMD = 0.79, 95 % CI = −0.18 ~ 1.75, P = 0.109; 72 h: SMD = 0.25, 95 % CI = −0.31 ~ 0.82, P = 0.380) (Fig. 2a)
Summary
We aimed to evaluate serum levels of S-100 beta (S-100β) and neuron specific enolase (NSE) in patients with coronary heart disease (CHD) after off-pump versus on-pump coronary artery bypass graft (CABG) surgery. Three therapeutic options are generally used for patients with CHD, including medical treatment with drugs, coronary interventions such as angioplasty and CABG surgery is a surgical procedure most commonly performed to relieve angina and reduce the risk of death from CHD [6]. The CABG surgery has significantly changed over the years, from traditional surgical operations using cardiopulmonary bypass (on-pump CABG) to a newer approach in cardiovascular surgery (off-pump CABG), both of which are primarily designed to improve the outcomes in CHD patients [7, 8].
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