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Release of S100B during coronary artery bypass grafting is reduced by off-pump surgery

R E Anderson1, L O Hansson, J Vaage

  • 1Department of Cardiothoracic Anaesthetics and Intensive Care, Karolinska Hospital, Stockholm, Sweden. russell.anderson@kirurgi.ki.se

The Annals of Thoracic Surgery
|July 3, 1999
PubMed

Insights

Coronary artery bypass grafting using cardiopulmonary bypass (CPB) significantly elevated S100B brain injury markers compared to off-pump procedures. Off-pump surgery with vein grafts showed a minor increase in S100B.

Area of Science:

  • Cardiovascular Surgery
  • Neuroscience
  • Biomarkers

Background:

  • S100B is a recognized plasma marker for brain injury.
  • Assessing S100B levels is crucial in cardiac surgical procedures.
  • Comparison of S100B levels in coronary artery bypass grafting (CABG) with and without cardiopulmonary bypass (CPB) is investigated.

Purpose of the Study:

  • To compare S100B plasma levels after coronary artery bypass grafting (CABG) performed with and without cardiopulmonary bypass (CPB).
  • To evaluate the impact of different surgical approaches (minithoracotomy vs. sternotomy) and graft types (arterial vs. venous) on S100B release.

Main Methods:

  • A comparative study involving 14 patients undergoing off-pump CABG and 18 patients undergoing CABG with CPB.
  • Off-pump patients were divided into minithoracotomy with arterial grafts and sternotomy with arterial and venous grafts.
  • S100B levels were quantified in arterial plasma using a highly sensitive immunoassay.

Main Results:

  • Pre-operative S100B levels were 0.03 microg/L.
  • Maximum S100B levels at wound closure were significantly higher in the CPB group (2.4 +/- 1.5 microg/L) compared to the off-pump group (0.22 +/- 0.07 microg/L) (p < 0.001).
  • Off-pump sternotomy with vein grafting showed a slightly greater S100B release than arterial grafting via minithoracotomy (p < 0.05). No strokes were reported in any group.

Conclusions:

  • Coronary artery bypass grafting with CPB results in a 10-fold greater increase in S100B compared to off-pump grafting.
  • The surgical approach for off-pump CABG influences S100B release, with sternotomy and vein grafting leading to a slightly higher elevation than minithoracotomy with arterial grafting.
  • CPB is associated with a more substantial release of the brain injury marker S100B.
Abstract

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