Impact of different timing of off-pump coronary artery bypass grafting on postoperatiue myocardial injury in patients with acute myocardial infarction
Luo Zijuan
Liu Keye
Luo Zhiqiang
Han Zhe
Zhou Xiaodong
Wang Yang
Abstract：Objective To observe the effect of different timing of off-pump coronary artery bypass grafting(OPCABG) on postoperatiue myocardial injury in patients with acute myocardial infarction(AMI).Methods A total of 89 AMI patients with relatively stable hemodynamics and normal myocardial enzyme beofore operation undergoing OPCABG from January 2016 to June 2017 in Affiliated Hospital of Hebei University,Beijing Chaoyang Hospital and Beijing Anzhen Hospital,Capital Medical University were enrolled.According to the infarction onset to operation time,the patients were divided into group A(8-14 d,n =27),group B(15-21 d,n =32) and group C(22-28 d,n =30).Venous blood was sampled before operation and 1,3,6,12,24 h after the first graft was perfused to test levels of cardiac troponin Ⅰ (cTnⅠ),ischemia-modified albumin (IMA) and heart-type fatty acid binding protein(H-FABP).Changes of left ventricular ejection fraction(LVEF) and perioperative mortality were observed.Results In 3 groups,cTnⅠ level 6,12,24 h after the first graft perfusion showed significant differences compared to that before operation(P ＜0.05);IMA level 1,3,6 h after the first graft perfusion showed significant differences compared to that before operation(P ＜ 0.05);H-FABP level 1,3,6,12 h after the first graft perfusion showed significant differences compared to that before operation [group A:(5.1 ± 1.2),(8.2 ± 1.3),(13.8 ±2.6),(10.4 ± 1.8) μg/L vs(4.2 ±0.9) μg/L;group B:(5.0 ± 1.0),(7.6 ±0.7),(13.3 ± 1.0),(9.9 ±0.9)μg/L vs (4.4 ±0.9) μg/L;group C:(4.4 ± 1.1),(7.9 ±0.7),(13.2 ±0.7),(9.6 ± 1.1)μg/L vs (4.0 ± 1.0) μg/L] (P ＜0.05).There were no significant differences of cTnⅠ,IMA,H-FABP levels among 3 groups(P ＞0.05).H-FABP level was positively correlated with cTnⅠ peak value(r =0.281,P =0.031).LVEF showed no significant difference before and after operation (P ＞ 0.05).No patients died during perioperative period.Conclusion It is relatively safe for AMI patients with relatively stable hemodynamics and normal myocardial enzyme beofore operation to have OPCABG in 2,3 or 4 weeks after infarction onset;the operation timing has no significant impact on postoperative myocardial injury.
Keywords：Acute myocardial infarctionOff-pump coronary artery bypassMyocardial injury
Publication Date：2018-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 691-695 )