Perioperative Clinical Significance Of Cardia Markers On Off-pump Versus On-pmup Coronary Artery Bypass Grafting

Objective To evaluate the clinical significance of serum cardiac markers in patients undergoing off-pump coronary artery bypass (OPCAB) and coronary artery bypass grafting(CABG).Methods Forty-six patients, ASAâ…¡-â…£, were randomly divided into two groups: OPCAB(group I) and CABG(group II). Serum CK, CK-MBmass,cTnT and Myo concentrations were measured before induction of anesthesia, immediately after ICU, and 6h, 24h after ICU. 12-leade ECG were monited and compared before, 1h after ICU, first and second day after ICU. Results The median value of CK, CK-MBmass,cTnT and Myo levels were all in normal range before operation, increased significantly immediately after and 6h, 24h after ICU. CK-MBmass,cTnT and Myo levels reached the highest levels 6h after ICU,whereas CK reached the highest level at 24h after ICU. CK, CK-MBmass and cTnT were significantly higher in group II compared with group I, both the degree of elevation and the proportion higher than the upper normal limit. In two groupos, CK-MBmass and cTnT showed significantly difference immediaely to 6h after ICU. CK and Myo did not display any significantly difference. CK-MBmass was related to cTnT in two groups.There was one PMI in gorup II with CK-MBmassï¹¥30ug/L the first day of postoperation, and the highest value of cTnT was 2.8ug/L. There were two cases in group I that were postoperative ECG with myocardial ischemic injury and CK-MBmassï¹¥30ug/L, one of them was cTnTï¹¥1.0ug/L. In group II , postoperative ECG with myocardial ischemic injury was recorded on seven patients, one of them with CK-MBmassï¹¥30ug/L and others with cTnTï¹¥1.0ug/L. There were significantly difference between group I and group II for operation time, emergence from anesthesia, extubation time and draw volume. Clnclusion CK-MBmass and cTnT are similar after postoperation, both could be used to evaluate the degree of perioperative myocareial injury, moreover cTnT is of larger diagnostic time window and higher sensitivity and specificity than CK-MBmass. Cardial markers level of myocardial injury in OPCAB group is lower than CABG group. Myo is lack of specificity as an marker of perioperative myocardial injury, but it need further study.