Application Of ASCABG In Cardiac Surgery And Its Relationship With The Level Of Anxiety Related Serous Biomarkers

BackgroundsCoronary atherosclerotic heart disease (CAD) normally affects people aged above 40, male severe than female. Up to 1989, cardiovascular disease has become the second or third cause of death respectively. Observations in 1996 suggested that cardiovascular cerebral diseases related mortality had accounted for 1/3 of the total mortality in China. On the basis of comprehensive prophylatic measurements, coronary artery bypass grafting surgery(CABG)is recognized as one of the most effective methods for CAD treating. Off-pump coronary artery bypass grafting (OPCABG) is a high-risk procedure, patients are more likely to be anxious in preoperative period. Therefore CAD patients should be the the most appropriate candidates for research of such sort. A variety number of case report and clinical trial and abroad demonstrated that CABG preoperative anxiety resulted in serious adverse cardiac events in patients undergoing CABG A considerably large numbers of CAD patients were included in one of our former clinical observation focusing on preoperative anxiety level from December 2005 to March 2006 in departments of cardiac surgery and anesthesiology of Bejing Anzhen hospital.By analysing and comparing practicability and advantages about different psychological evaluation questionnaire, we compiled Preoperative Anxiety Scale for Cardiac Surgery Patients(ASCABG) based on previous studies combining clinical observation and previous trials.At present, the preoperative anxiety evaluation is mainly based on subjective aspects, but the objective anxiety evaluation of patients is relatively scarce.Through ASCABG and serum markers analysis,this research comprehensively evaluated preoperative anxiety conditions of CAD patients undergoing OPCABG.PurposeThe purpose of present study is to provide effective preoperative treatment references for anesthesiologists and heart medical staffs, by monitoring preoperative anxiety symptoms, special scale analysis and stress related serological biomarkers of patients undergoing OPCABG. Methods50 patients undergoing elective OPCABG were randomly included in present study. Patients were asked to independently filled out ASCABG、HAMD sacles. At the beginning of the study, professional psychologists trained anesthesiologists, and then the anesthesiologists made a comprehensive evaluation for the patient.5ml of venous blood were collected for every patients at four time points including the 2nd day morning after hopitalized,1st day before operation, operative day morning, the moment before induction of general anesthesia, at the same time, blood pressure、heart rate were recorded and blood sugar, test of Cortisol (COR)、Angiotension II (A II)、Epinephrine (E) and Norepinephrine (NE) were analyzed by radicalization immunity and enzyme lummunoassay method. Variables acquired at different time points were undergoing analysis of variance for repeated measurement data. P value less than 0.05 was consideredstatistically significant.Conclusion1. ASCABG statistics results indicate that it is feasible for ASCABG to observe preoperative anxiety of OPCABG patients and that OPCABG patients have serious preoperative anxiety.2. There are correlations between ASCABG and traditional anxiety scale HAMA for observing preoperative anxiety of cardiac surgery patients. However, HAMA can not accurately measure real anxiety reaction Because of confused physiological symptoms and somatic symptoms. ASCABG observes clinic and mental manifestations; analyzes advantages and disadvantages of different mental analysis tools based on preoperative anxiety of large sample of CAD patients; and uses pre-made professional measuring scale base on pre-test results. Therefore, ASCABG is more suitable for the anxiety evaluation than traditional HAMA.3. Changing trends of serologic index representing CABG patients anxiety and general anxiety signs are consistent, and serologic index correlates well with general anxiety signs.4. Serologic index and general signs changing trends representing OPCABG patients anxiety indicate anxiety level of patients are the most serious on the last night before operation.