Systemic Inflammation After On-Pump and Off-Pump Coronary Bypass Surgery: A One-Month Follow-Up

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Abstract

Background: This study sought to assess inflammation activation in the follow-up (up to one month) of coronary bypass surgery performed both on- (CABG) and off-pump (OPCAB). Methods: Thirty patients, candidates for coronary surgery, were randomized to undergo CABG (n = 16) or OPCAB (n = 14). Blood samples were collected before the intervention, after protamine administration, and 4, 8, and 30 days after surgery. Results: Plasma tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels significantly increased with respect to baseline from protamine administration up to eight postoperative days, whereas high-sensitivity C-reactive protein (hs-CRP) and fibrinogen increased after surgery up to eight postoperative days in both groups. On the other hand, neutrophil elastase levels were higher than baseline from protamine administration up to four postoperative days in CABG, and at the time point eight days after surgery in OPCAB. The only significant differences between CABG and OPCAB in inflammatory markers occurred intraoperatively, after protamine administration, when TNF-α and elastase levels were higher in CABG, whereas no differences were detected between CABG and OPCAB at any postoperative time point. Postoperative increases in fibrinogen and hs-CRP were positively correlated with increases in IL-6, but not with postoperative changes in TNF-α both in CABG and OPCAB. Conclusions: After coronary bypass surgery, there is a protracted postoperative activation of inflammation persisting several days after surgery; this postoperative activation is not affected by the surgical strategy (on-pump or off-pump).

Original languageEnglish
Pages (from-to)823-828
Number of pages6
JournalAnnals of Thoracic Surgery
Volume84
Issue number3
DOIs
Publication statusPublished - Sep 2007

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Protamines
Ambulatory Surgical Procedures
Inflammation
Tumor Necrosis Factor-alpha
C-Reactive Protein
Fibrinogen
Interleukin-6
Leukocyte Elastase
Pancreatic Elastase

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

@article{2246acd5110543888590bc81f19dbb8d,
title = "Systemic Inflammation After On-Pump and Off-Pump Coronary Bypass Surgery: A One-Month Follow-Up",
abstract = "Background: This study sought to assess inflammation activation in the follow-up (up to one month) of coronary bypass surgery performed both on- (CABG) and off-pump (OPCAB). Methods: Thirty patients, candidates for coronary surgery, were randomized to undergo CABG (n = 16) or OPCAB (n = 14). Blood samples were collected before the intervention, after protamine administration, and 4, 8, and 30 days after surgery. Results: Plasma tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels significantly increased with respect to baseline from protamine administration up to eight postoperative days, whereas high-sensitivity C-reactive protein (hs-CRP) and fibrinogen increased after surgery up to eight postoperative days in both groups. On the other hand, neutrophil elastase levels were higher than baseline from protamine administration up to four postoperative days in CABG, and at the time point eight days after surgery in OPCAB. The only significant differences between CABG and OPCAB in inflammatory markers occurred intraoperatively, after protamine administration, when TNF-α and elastase levels were higher in CABG, whereas no differences were detected between CABG and OPCAB at any postoperative time point. Postoperative increases in fibrinogen and hs-CRP were positively correlated with increases in IL-6, but not with postoperative changes in TNF-α both in CABG and OPCAB. Conclusions: After coronary bypass surgery, there is a protracted postoperative activation of inflammation persisting several days after surgery; this postoperative activation is not affected by the surgical strategy (on-pump or off-pump).",
author = "Alessandro Parolari and Marina Camera and Francesco Alamanni and Moreno Naliato and Polvani, {Gian Luca} and Marco Agrifoglio and Marta Brambilla and Carla Biancardi and Luciana Mussoni and Paolo Biglioli and Elena Tremoli",
year = "2007",
month = "9",
doi = "10.1016/j.athoracsur.2007.04.048",
language = "English",
volume = "84",
pages = "823--828",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
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number = "3",

}

TY - JOUR

T1 - Systemic Inflammation After On-Pump and Off-Pump Coronary Bypass Surgery

T2 - A One-Month Follow-Up

AU - Parolari, Alessandro

AU - Camera, Marina

AU - Alamanni, Francesco

AU - Naliato, Moreno

AU - Polvani, Gian Luca

AU - Agrifoglio, Marco

AU - Brambilla, Marta

AU - Biancardi, Carla

AU - Mussoni, Luciana

AU - Biglioli, Paolo

AU - Tremoli, Elena

PY - 2007/9

Y1 - 2007/9

N2 - Background: This study sought to assess inflammation activation in the follow-up (up to one month) of coronary bypass surgery performed both on- (CABG) and off-pump (OPCAB). Methods: Thirty patients, candidates for coronary surgery, were randomized to undergo CABG (n = 16) or OPCAB (n = 14). Blood samples were collected before the intervention, after protamine administration, and 4, 8, and 30 days after surgery. Results: Plasma tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels significantly increased with respect to baseline from protamine administration up to eight postoperative days, whereas high-sensitivity C-reactive protein (hs-CRP) and fibrinogen increased after surgery up to eight postoperative days in both groups. On the other hand, neutrophil elastase levels were higher than baseline from protamine administration up to four postoperative days in CABG, and at the time point eight days after surgery in OPCAB. The only significant differences between CABG and OPCAB in inflammatory markers occurred intraoperatively, after protamine administration, when TNF-α and elastase levels were higher in CABG, whereas no differences were detected between CABG and OPCAB at any postoperative time point. Postoperative increases in fibrinogen and hs-CRP were positively correlated with increases in IL-6, but not with postoperative changes in TNF-α both in CABG and OPCAB. Conclusions: After coronary bypass surgery, there is a protracted postoperative activation of inflammation persisting several days after surgery; this postoperative activation is not affected by the surgical strategy (on-pump or off-pump).

AB - Background: This study sought to assess inflammation activation in the follow-up (up to one month) of coronary bypass surgery performed both on- (CABG) and off-pump (OPCAB). Methods: Thirty patients, candidates for coronary surgery, were randomized to undergo CABG (n = 16) or OPCAB (n = 14). Blood samples were collected before the intervention, after protamine administration, and 4, 8, and 30 days after surgery. Results: Plasma tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels significantly increased with respect to baseline from protamine administration up to eight postoperative days, whereas high-sensitivity C-reactive protein (hs-CRP) and fibrinogen increased after surgery up to eight postoperative days in both groups. On the other hand, neutrophil elastase levels were higher than baseline from protamine administration up to four postoperative days in CABG, and at the time point eight days after surgery in OPCAB. The only significant differences between CABG and OPCAB in inflammatory markers occurred intraoperatively, after protamine administration, when TNF-α and elastase levels were higher in CABG, whereas no differences were detected between CABG and OPCAB at any postoperative time point. Postoperative increases in fibrinogen and hs-CRP were positively correlated with increases in IL-6, but not with postoperative changes in TNF-α both in CABG and OPCAB. Conclusions: After coronary bypass surgery, there is a protracted postoperative activation of inflammation persisting several days after surgery; this postoperative activation is not affected by the surgical strategy (on-pump or off-pump).

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U2 - 10.1016/j.athoracsur.2007.04.048

DO - 10.1016/j.athoracsur.2007.04.048

M3 - Article

C2 - 17720383

AN - SCOPUS:34548033009

VL - 84

SP - 823

EP - 828

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 3

ER -