İbrahim KARA, Nilgün BOZBUĞA, Kaan KIRALİ, Başer SAREYYÜPOĞLU, Esat AKINCI, Cevat YAKUT, Sinan DAĞDELEN, Hasan Basri ERDOĞAN

Myocardial injury in off-pump coronary surgery: a comparative study of off-pump versus coronary intervention

Amaç: Bu prospektif çalışmada, off-pump koroner arter bypass cerrahisi ile koroner girişim yapılarak elektif koroner revaskülarizasyon uygulanan hastalarda miyokardiyal hasar düzeyleri karşılaştırıldı. Çalışma planı: Çalışmaya, koroner arter hastalığı nedeniyle off-pump koroner cerrahisi (n=50) veya koroner girişimle stent implantasyonu (n=50) uygulanan ardışık 100 hasta (83 erkek, 17 kadın; ort. yaş 53; dağılım 34-78) alındı. Miyokard hasarı derecesini belirlemek için, girişim öncesi ve girişimden 12 saat sonra kan örnekleri alınarak, kardiyak troponin (cTn), kreatin kinaz MB (CK-MB), high sensitive CRP (hsCRP) ve laktat düzeyleri ölçüldü ve elektrokardiyografik değerlendirme yapıldı.Bulgular: İki grup arasında sigara içme, aspirin kullanımı, geçirilmiş miyokard infarktüsü ve sol ventrikül ejeksiyon fraksiyonu açısından anlamlı farklılık vardı. Tutulan damar sayısı ise benzer bulundu. Başlangıç değerleriyle kıyaslandığında, off-pump cerrahi ve koroner girişim uygulamalarında cTn’de artış sırasıyla %7.1 ve %2.0, CK-MB’deki artış %2.0 ve %1.2 (p

Off-pump koroner cerrahide miyokard hasarı: Off-pump cerrahi ile girişimsel yöntemi karşılaştırma

Background: In this prospective study, we compared the degree of myocardial injury in patients undergoing elective coronary interventions (CI) for revascularization or off-pump coronary artery bypass surgery (OPCAB). Methods: The study included 100 consecutive patients (83 males, 17 females; mean age 53 years; range 34 to 78 years) who underwent intracoronary stent implantation (n=50) or OPCAB (n=50) for coronary artery disease. To evaluate the degree of myocardial injury, blood samples were taken preoperatively and at postoperative 12 hours to measure cardiac troponin (cTn), creatine kinase MB (CKMB), high sensitive CRP (hsCRP), and lactate levels. A 12-lead electrocardiogram was obtained before and following the procedure.Results: There were significant differences between the two groups with regard to smoking, acetyl salicylic acid use, previous history of myocardial infarction, and left ventricular ejection fraction, whereas the mean number of affected vessels was similar. Compared to the basal values, cTn levels increased by 7.1% and 2.0%, CK-MB activity increased by 2.0% and 1.2% following OPCAB and CI, respectively (p

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