Levels of Ischemia: Modified Albumin in Patients Undergoing On-pump Coronary Artery Bypass

OBJECTIVE: To investigate the effect of ischemia-modified albumin (IMA) during cardiopulmonary bypass (CPB). STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Cardiovascular Surgery, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey, between January and April 2018. METHODOLOGY: Patients, who underwent on-pump coronary bypass surgery, were inducted. IMA levels were measured in the preoperative period (IMA-T1), 30 minutes after removal of aortic X-clamp (IMA-T2) (ischemic period) and 6th hours (IMA-T3) after surgery. The groups were formed according to the average value of IMA-T2 levels measured in the ischemic period. Those with a value above the mean (0.76 U/mL) were grouped as group 1 and those below the mean were grouped as group 2. Postoperative data of the patients were recorded. RESULTS: There were significant differences between measured IMA levels in different periods of on-pump CABG (p <0.001). The development of postoperative atrial fibrillation (PoAF) was higher in Group 1 and this result was statistically significant (p=0.004). High IMA-T2 levels were detected as an independent parameter in predicting the PoAF development (p=0.04, logistic regression analysis). ROC curve analysis demonstrated IMA-T2 values of 0.73 or above could predict development PoAF with 82.6% sensitivity and 66.7% specificity (AUC: 0.777, log rank p=0.001). CONCLUSION: Increased IMA levels during ischemic period may be predictive in PoAF development.