Molecular pathways activation in coronary artery bypass surgery

Which role for pump avoidance?

Research output: Contribution to journalArticle

Abstract

In this study, we review current knowledge regarding molecular pathways activation and their possible mechanisms in the perioperative period of coronary artery bypass surgery (CABG). We also highlight the role of off-pump CABG as a possible way to better understand these biological changes. We show that, after both on-pump and off-pump CABG, there is a marked and protracted activation of several molecular pathways indicating increased inflammatory status, haemostasis activation, as well as increased oxidative stress and unfavourable endothelial milieu. These changes persist for days and even weeks after surgery. Interestingly, a relatively limited number of these pathways show a more pronounced activation in case of cardiopulmonary bypass use, and these markers are mainly associated with oxidative stress activation; on the contrary, the vast majority of the pathways has a similar course both in on and off-pump procedures. Surgical stress accounts for more protracted and marked molecular pathway perturbations overall, being the effect of cardiopulmonary, if any, limited to the very early hours after surgery. The near future of the translational research in coronary bypass surgery is to develop therapeutic strategies aimed at reducing this response, that is largely unrelated to cardiopulmonary bypass use, in order to reduce perioperative complications and to speed up patients' recovery.

Original languageEnglish
Pages (from-to)55-61
Number of pages7
JournalJournal of Cardiovascular Medicine
Volume17
Issue number1
DOIs
Publication statusPublished - 2016

Fingerprint

Coronary Artery Bypass
Off-Pump Coronary Artery Bypass
Cardiopulmonary Bypass
Oxidative Stress
Perioperative Period
Translational Medical Research
Hemostasis
Therapeutics

Keywords

  • cardiopulmonary bypass
  • coronary artery bypass
  • iomarkers
  • outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{4add06a991444fc7906f3d0c2775953d,
title = "Molecular pathways activation in coronary artery bypass surgery: Which role for pump avoidance?",
abstract = "In this study, we review current knowledge regarding molecular pathways activation and their possible mechanisms in the perioperative period of coronary artery bypass surgery (CABG). We also highlight the role of off-pump CABG as a possible way to better understand these biological changes. We show that, after both on-pump and off-pump CABG, there is a marked and protracted activation of several molecular pathways indicating increased inflammatory status, haemostasis activation, as well as increased oxidative stress and unfavourable endothelial milieu. These changes persist for days and even weeks after surgery. Interestingly, a relatively limited number of these pathways show a more pronounced activation in case of cardiopulmonary bypass use, and these markers are mainly associated with oxidative stress activation; on the contrary, the vast majority of the pathways has a similar course both in on and off-pump procedures. Surgical stress accounts for more protracted and marked molecular pathway perturbations overall, being the effect of cardiopulmonary, if any, limited to the very early hours after surgery. The near future of the translational research in coronary bypass surgery is to develop therapeutic strategies aimed at reducing this response, that is largely unrelated to cardiopulmonary bypass use, in order to reduce perioperative complications and to speed up patients' recovery.",
keywords = "cardiopulmonary bypass, coronary artery bypass, iomarkers, outcomes",
author = "Alessandro Parolari and Paolo Poggio and Veronika Myasoedova and Paola Songia and Alberto Pilozzi and Francesco Alamanni and Elena Tremoli",
year = "2016",
doi = "10.2459/JCM.0000000000000293",
language = "English",
volume = "17",
pages = "55--61",
journal = "Journal of Cardiovascular Medicine",
issn = "1558-2027",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Molecular pathways activation in coronary artery bypass surgery

T2 - Which role for pump avoidance?

AU - Parolari, Alessandro

AU - Poggio, Paolo

AU - Myasoedova, Veronika

AU - Songia, Paola

AU - Pilozzi, Alberto

AU - Alamanni, Francesco

AU - Tremoli, Elena

PY - 2016

Y1 - 2016

N2 - In this study, we review current knowledge regarding molecular pathways activation and their possible mechanisms in the perioperative period of coronary artery bypass surgery (CABG). We also highlight the role of off-pump CABG as a possible way to better understand these biological changes. We show that, after both on-pump and off-pump CABG, there is a marked and protracted activation of several molecular pathways indicating increased inflammatory status, haemostasis activation, as well as increased oxidative stress and unfavourable endothelial milieu. These changes persist for days and even weeks after surgery. Interestingly, a relatively limited number of these pathways show a more pronounced activation in case of cardiopulmonary bypass use, and these markers are mainly associated with oxidative stress activation; on the contrary, the vast majority of the pathways has a similar course both in on and off-pump procedures. Surgical stress accounts for more protracted and marked molecular pathway perturbations overall, being the effect of cardiopulmonary, if any, limited to the very early hours after surgery. The near future of the translational research in coronary bypass surgery is to develop therapeutic strategies aimed at reducing this response, that is largely unrelated to cardiopulmonary bypass use, in order to reduce perioperative complications and to speed up patients' recovery.

AB - In this study, we review current knowledge regarding molecular pathways activation and their possible mechanisms in the perioperative period of coronary artery bypass surgery (CABG). We also highlight the role of off-pump CABG as a possible way to better understand these biological changes. We show that, after both on-pump and off-pump CABG, there is a marked and protracted activation of several molecular pathways indicating increased inflammatory status, haemostasis activation, as well as increased oxidative stress and unfavourable endothelial milieu. These changes persist for days and even weeks after surgery. Interestingly, a relatively limited number of these pathways show a more pronounced activation in case of cardiopulmonary bypass use, and these markers are mainly associated with oxidative stress activation; on the contrary, the vast majority of the pathways has a similar course both in on and off-pump procedures. Surgical stress accounts for more protracted and marked molecular pathway perturbations overall, being the effect of cardiopulmonary, if any, limited to the very early hours after surgery. The near future of the translational research in coronary bypass surgery is to develop therapeutic strategies aimed at reducing this response, that is largely unrelated to cardiopulmonary bypass use, in order to reduce perioperative complications and to speed up patients' recovery.

KW - cardiopulmonary bypass

KW - coronary artery bypass

KW - iomarkers

KW - outcomes

UR - http://www.scopus.com/inward/record.url?scp=84948574357&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948574357&partnerID=8YFLogxK

U2 - 10.2459/JCM.0000000000000293

DO - 10.2459/JCM.0000000000000293

M3 - Article

VL - 17

SP - 55

EP - 61

JO - Journal of Cardiovascular Medicine

JF - Journal of Cardiovascular Medicine

SN - 1558-2027

IS - 1

ER -