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Creatine phosphokinase did not increase after on-pump beating heart coronary artery bypass graft early after acute myocardial infarction
並列摘要
Aims: Emergency coronary artery bypass grafting (CABG) is sometimes mandatory although operative mortality is high within 24 hours after the onset of acute myocardial infarction (AMI). We have used on-pump beating heart (OPBH) CABG to reduce injury to non-infarcted myocardium during CABG. We compared clinical outcomes of OPBH with those of conventional CABG with cardiac arrest (OPCA), both performed within 24 hours after the onset of AMI. Methods: Twenty-two patients were enrolled in this study. Patients’ basic characteristics, operative procedure, in-hospital mortality, morbidity and changes in creatine phosphokinase (CPK) and myocardial subset of CPK (creatine phosphokinase-myoglobin binding, CPK-MB) and ejection fraction (EF) were retrospectively obtained by reviewing hospital records. Results: In the OPCA group, postoperative increases were seen in mean CPK (p=0.03) and in CPK-MB (p=0.03). In the OPBH group, postoperative decreases were seen in mean CPK (p=0.43) and in CPK-MB (p=0.07). Ejection fraction increased postoperatively in both groups, although the increase in OPCA was not significant. No statistically significant differences were found in mortality and morbidity between OPCA and OPBH. Conclusion: In our study, OPBH did not increase CPK and CPK-MB in early AMI treatment, suggesting that OPBH may reduce myocardial injury during CABG performed very early after AMI although further studies including randomized trial are warranted.
延伸閱讀
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