Key result
Off-pump CABG shows no difference in postoperative CRP levels compared with on-pump CABG.
Why the study?
Does on-pump coronary artery bypass increase postoperative ultrasensitive C-reactive protein levels compared to off-pump coronary artery bypass in patients with multi-vessel coronary artery disease?
Observational (n=136)
non-randomized
No
Does on-pump coronary artery bypass increase postoperative ultrasensitive C-reactive protein levels compared to off-pump coronary artery bypass in patients with multi-vessel coronary artery disease?
p-value: p=0.867
The systemic inflammatory response, as measured by US-CRP, is similarly elevated following both on-pump and off-pump CABG, suggesting cardiopulmonary bypass is not the primary trigger.
Similar US-CRP rises after on- and off-pump CABG should not yet change technique selection; leaves open bypass as primary inflammatory driver.
OBJECTIVE: To analyze the inflammation resulting from myocardial revascularization techniques with and without cardiopulmonary bypass, based on ultrasensitive C-reactive protein (US-CRP) behavior. METHODS: A prospective non-randomized clinical study with 136 patients was performed. Sixty-nine patients were enrolled for Group 1 (on-pump coronary artery bypass - ONCAB) and 67 patients were assigned to Group 2 (off-pump coronary artery bypass - OPCAB). All study participants had blood samples collected for analysis of glucose, triglycerides, creatinine, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and creatinephosphokinase (CPK) in the preoperative period. The samples of creatinephosphokinase MB (CKMB), troponin I (TnI) and US-CRP were collected in the preoperative period and at 6, 12, 24, 36, 48 and 72 hours after surgery. We also analyzed the preoperative biological variables of each patient (age, smoking, diabetes mellitus, left coronary trunk lesion, body mass index, previous myocardial infarction, myocardial fibrosis). All angiographically documented patients with >70% proximal multiarterial stenosis and ischemia, documented by stress test or classification of stable angina (class II or III), according to the Canadian Cardiovascular Society, were included. Reoperations, combined surgeries, recent acute myocardial infarction, recent inflammatory disease, deep venous thrombosis or recent pulmonary thromboembolism, acute kidney injury or chronic kidney injury were not included. RESULTS: Correlation values between the US-CRP curve and the ONCAB group, the treatment effect and the analyzed biological variables did not present expressive results. Laboratory variables were evaluated and did not correlate with the applied treatment (P>0.05). CONCLUSION: The changes in the US-CRP at each moment evaluated from the postoperative period did not show any significance in relation to the surgical technique applied.
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Abrantes et al. (2018) conducted an observational in Coronary artery disease requiring revascularization (n=136). On-pump coronary artery bypass (ONCAB) vs. Off-pump coronary artery bypass (OPCAB) was evaluated on Ultrasensitive C-reactive protein (US-CRP) levels (p=0.867). On-pump and off-pump coronary artery bypass grafting both significantly increased postoperative ultrasensitive C-reactive protein levels, with no significant difference between the two techniques (P=0.867).
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