ARYA Atherosclerosis Journal

Association of cardiac enzymes with morbidity and mortality of patients undergoing coronary endarterectomy surgery

Document Type : Original Article(s)

Authors

Aghigh Heydari 1
Feridoun Sabzi 1
Atefeh Asadmobini 1
Soudabeh Eskandari 2

1 Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Department of Biostatistics and Epidemiology, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran

https://doi.org/10.22122/arya.v17i0.2085
Abstract
BACKGROUND: The relationship between cardiac enzyme release following coronary endarterectomy (CE) and morbidity and mortality is unclear. Therefore, the present study aimed to investigate the association of cardiac enzymes with morbidity and mortality of patients undergoing CE surgery.METHODS: This was a single-center retrospective cohort study of 475 patients who had undergone off-pump coronary artery bypass graft (OPCABG). The patients were followed up for a mean of 72.99 ± 14.60 months.RESULTS: Among 475 patients undergoing OPCABG, 39 (8.2%) were non-survivors. Non-survivors were younger and had a fewer ejection fraction (EF). Comorbidities were similar in survivors and non-survivors. The crude Cox regression analysis showed that creatine kinase-myocardial band (CK-MB) had a protective effect against mortality, but when adjusted with age, sex, diabetes mellitus (DM), hypertension (HTN), hyperlipidemia, smoking, family history, body mass index (BMI), left main disease (LMD), and EF, this effect disappeared. Troponin in crude and adjusted analysis did not have any significant effect.CONCLUSION: There is no association between CK-MB and troponin and mortality in patients undergoing coronary artery bypass graft (CABG).

Keywords

Biomarkers
Coronary Artery Bypass, Off-Pump
Creatine Kinase, MB Form
Endarterectomy
Troponin
  1. Okrainec K, Banerjee DK, Eisenberg MJ. Coronary artery disease in the developing world. Am Heart J 2004; 148(1): 7-15.
  2. Alreshidan M, Albabtain M, Obied H, Alassal M, Albaradai A, Alghofaili F. Does coronary endarterectomy increase early mortality and morbidity compared with coronary artery bypass surgery alone-single centre experience. Int J Clin Med 2014; 5(5): 197-205.
  3. Abid AR, Farogh A, Naqshband MS, Akhtar RP, Khan JS. Hospital outcome of coronary artery bypass grafting and coronary endarterectomy. Asian Cardiovasc Thorac Ann 2009; 17(1): 59-63.
  4. Hussain I, Ghaffar A, Shahbaz A, Sami W, Muhammad A, Seher N, et al. In hospital outcome of patients undergoing coronary endarterectomy: Comparison between off-pump vs on pump CABG. J Ayub Med Coll Abbottabad 2008; 20(1): 31-7.
  5. Marzban M, Karimi A, Ahmadi H, Davoodi S, Abbasi K, Movahedi N, et al. Early outcomes of double-vessel coronary endarterectomy in comparison with single-vessel coronary endarterectomy. Tex Heart Inst J 2008; 35(2): 119-24.
  6. Schwann TA, Zacharias A, Riordan CJ, Durham SJ, Shah AS, Habib RH. Survival and graft patency after coronary artery bypass grafting with coronary endarterectomy: Role of arterial versus vein conduits. Ann Thorac Surg 2007; 84(1): 25-31.
  7. Lehrke S, Steen H, Sievers HH, Peters H, Opitz A, Muller-Bardorff M, et al. Cardiac troponin T for prediction of short- and long-term morbidity and mortality after elective open heart surgery. Clin Chem 2004; 50(9): 1560-7.
  8. Soylu E, Harling L, Ashrafian H, Casula R, Kokotsakis J, Athanasiou T. Adjunct coronary endarterectomy increases myocardial infarction and early mortality after coronary artery bypass grafting: A meta-analysis. Interact Cardiovasc Thorac Surg 2014; 19(3): 462-73.
  9. Nesher N, Alghamdi AA, Singh SK, Sever JY, Christakis GT, Goldman BS, et al. Troponin after cardiac surgery: A predictor or a phenomenon? Ann Thorac Surg 2008; 85(4): 1348-54.
  10. Croal BL, Hillis GS, Gibson PH, Fazal MT, El-Shafei H, Gibson G, et al. Relationship between postoperative cardiac troponin I levels and outcome of cardiac surgery. Circulation 2006; 114(14): 1468-75.
  11. Ramsay J, Shernan S, Fitch J, Finnegan P, Todaro T, Filloon T, et al. Increased creatine kinase MB level predicts postoperative mortality after cardiac surgery independent of new Q waves. J Thorac Cardiovasc Surg 2005; 129(2): 300-6.
  12. Klatte K, Chaitman BR, Theroux P, Gavard JA, Stocke K, Boyce S, et al. Increased mortality after coronary artery bypass graft surgery is associated with increased levels of postoperative creatine kinase-myocardial band isoenzyme release: Results from the GUARDIAN trial. J Am Coll Cardiol 2001; 38(4): 1070-7.
  13. Greenson N, Macoviak J, Krishnaswamy P, Morrisey R, James C, Clopton P, et al. Usefulness of cardiac troponin I in patients undergoing open heart surgery. Am Heart J 2001; 141(3): 447-55.
  14. Fellahi JL, Gue X, Richomme X, Monier E, Guillou L, Riou B. Short- and long-term prognostic value of postoperative cardiac troponin I concentration in patients undergoing coronary artery bypass grafting. Anesthesiology 2003; 99(2): 270-4.
  15. Burtis CA, Bruns DE. Tietz fundamentals of clinical chemistry and molecular diagnostics - E-Book. Philadelphia, PA: Elsevier Health Sciences; 2014.
  16. Domanski MJ, Mahaffey K, Hasselblad V, Brener SJ, Smith PK, Hillis G, et al. Association of myocardial enzyme elevation and survival following coronary artery bypass graft surgery. JAMA 2011; 305(6): 585-91.
  17. Soraas CL, Friis C, Engebretsen KV, Sandvik L, Kjeldsen SE, Tonnessen T. Troponin T is a better predictor than creatine kinase-MB of long-term mortality after coronary artery bypass graft surgery. Am Heart J 2012; 164(5): 779-85.
  18. Sabzi F, Asadmobini A, Ghasemi F. In-hospital outcome of patients undergoing off-pump coronary artery bypass graft with and without coronary endarterectomy. Res Cardiovasc Med 2017;
  19. (2): e38872.
  20. Sabzi F, Asadmobini A, Rezaei M. Comparing short and long term survival of patients undergoing off pump coronary artery bypass graft with and without coronary endarterectomy. Indian Heart J 2017; 69(5): 646-50.
  21. Newall N, Oo AY, Palmer ND, Grayson AD, Hine TJ, Stables RH, et al. Intermediate and high peri-operative cardiac enzyme release following isolated coronary artery bypass surgery are independently associated with higher one-year mortality. J Cardiothorac Surg 2006; 1: 20.
  22. Costa MA, Carere RG, Lichtenstein SV, Foley DP, de Valk V, Lindenboom W, et al. Incidence, predictors, and significance of abnormal cardiac enzyme rise in patients treated with bypass surgery in the arterial revascularization therapies study (ARTS). Circulation 2001; 104(22): 2689-93.
  23. Brener SJ, Lytle BW, Schneider JP, Ellis SG, Topol EJ. Association between CK-MB elevation after percutaneous or surgical revascularization and three-year mortality. J Am Coll Cardiol 2002; 40(11): 1961-7.
  24. Chowdhury UK, Malik V, Yadav R, Seth S, Ramakrishnan L, Kalaivani M, et al. Myocardial injury in coronary artery bypass grafting: On-pump versus off-pump comparison by measuring high-sensitivity C-reactive protein, cardiac troponin I, heart-type fatty acid-binding protein, creatine kinase-MB, and myoglobin release. J Thorac Cardiovasc Surg 2008; 135(5): 1110-9.
ARYA Atherosclerosis Journal
Volume 17, Issue 1
January and February 2021
Pages 1-5

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us