Effects Of On-pump CABG And Off-pump CABG On Myocardial Injury Using Multi-index

Objective:The present study is to evaluate the different postoperative change of myocardial injury and hemodynamics in patients undergoing off-pump CABG or on-pump CABG.Methods:30patients admitted for CABG were divided into two group:One group of patients were performed on-pump CABG, and another group of patients were performed off-pump CABG. All operations were performed by the same doctor team. Collect blood sample for detecting CK-MB, cTnI, hs-CRP at the time point of T0(after anesthesia but before anastomosed the first bypass graft) and1,2,3days after operation(T1,T2,T3) and detecting NT-proBNP at time point TO and1,5,7days after operation(T1,T5,T7). Documented hemodynamics and echocardiography parameters before and after operation. The clinic date of inotropes requirement, drainage, ICU time were routinely recorded.Results:CK-MB level of off-pump CABG is lower than on-pump CABG at T2and T3(off-pump CABG vs. on-pump CABG:18.39+7.90U/L vs.46.47±27.15U/L,14.63±11.61U/L vs.26.60±16.95U/L P<0.05). cTnI level of off-pump CABG is lower than on-pump CABG at T1, T2and T3also(off-pump CABG vs. on-pump CABG:0.62±0.75ng/mL vs.4.42±6.41ng/mL,0.37±0.47ng/mL vs.4.92±6.00ng/mL,0.31±0.33ng/mL vs.2.04±2.77ng/mL,P<0.05). The NT-proBNP concentration of off-pump CABG group is significantly lower than on-pump CABG at T1, T5and T7(off-pump CABG vs. on-pump CABG:1150.50±966.49pg/ml vs.3829.65±3761.84pg/ml,959.88±856.04pg/ml vs.2374.34±1492.85pg/ml,567.87±628.536pg/ml vs. 1999.41±1176.211pg/ml, P<0.05). There is no significant difference on hs-CRP at T1,T2and T3between the two group (P>0.05). Postoperative parameter of LVSWI of off-pump CABG group is higher than on-pump CABG(33.64±6.05g.m.m2vs.23.03±7.12g.m.m2, P<0.05). Postoperative parameter of PCWP of off-pump CABG group is lower than on-pump CABG(16.27±3.73mmHg vs.19.47±3.09mmHg, P<0.05).Conclusions:The study suggests that the off-pump CABG reduces myocardial injury.