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Correlation between inflammatory response and markers of neuronal damage in coronary revascularization with and
Annamaria Mazzone1, Jacopo Gianetti, Eugenio Picano
1Cardiac Surgery Department, CNR Institute of Clinical Physiology, Ospedale G. Pasquinucci, Massa, Italy. mazzone@ifc_cnr.pi.it
Insights
Off-pump coronary artery bypass graft (CABG) surgery demonstrates a reduced inflammatory response and neuronal damage compared to on-pump procedures. This study highlights the protective benefits of off-pump CABG in minimizing perioperative injury markers.
Area of Science:
- Cardiovascular Surgery
- Neuroscience
- Immunology
Background:
- Conventional coronary artery bypass graft (CABG) surgery utilizes cardiopulmonary bypass, which can trigger inflammatory responses and neuronal damage.
- Off-pump CABG is a surgical technique that avoids cardiopulmonary bypass, potentially mitigating these adverse effects.
Purpose of the Study:
- To investigate the protective effects of off-pump CABG surgery.
- To compare plasma inflammatory and neuronal injury markers between on-pump and off-pump CABG procedures.
Main Methods:
- A comparative study involving 41 patients undergoing elective CABG: 21 on-pump (Group I) and 20 off-pump (Group II).
- Perioperative measurement of inflammatory markers: interleukin-2 receptor (IL-2r), interleukin-6 (IL-6), and tumor necrosis factor-alpha.
- Perioperative measurement of neuronal injury markers: S-100 protein (S-100) and neuron-specific enolase (NSE).
Main Results:
- Significantly lower postoperative peak values of NSE (p < 0.001) and S-100 (p < 0.05) were observed in the off-pump group (Group II).
- Interleukin-6 (IL-6) levels were significantly lower in off-pump patients (p < 0.001).
- A significant correlation was found between NSE and IL-6 levels (p < 0.001).
Conclusions:
- Off-pump CABG surgery effectively reduces the inflammatory response during the perioperative period.
- The technique also minimizes the release of neuronal damage markers, suggesting neuroprotective benefits.
- The correlation between inflammatory markers and neuronal markers indicates a potential link between systemic inflammation and neuronal injury in CABG patients.
Abstract:
Off-pump coronary artery bypass graft (CABG) surgery may reduce the inflammatory response and the neuronal damage associated with conventional CABG on cardiopulmonary bypass. The purpose of this study was to explore the protective effect of off-pump surgery by assessing plasma inflammatory and neuronal injury markers. Forty-one patients with coronary artery disease undergoing elective CABG were examined: 21 on-pump (Group I) and 20 off-pump (Group II). The perioperative release of interleukin-2 receptor (IL-2r), IL-6, tumor necrosis factor-alpha, S-100 protein (S-100) and neuron-specific enolase (NSE) were measured. Postoperative peak values of NSE (p < 0.001) and S-100 (p < 0.05) were significantly lower in Group II. IL-6 showed significantly lower values in off-pump patients (p < 0.001). A significant correlation was found between NSE and IL-6 (p < 0.001). In conclusion, off-pump surgery reduces the inflammatory response as well as the perioperative release of neuronal damage markers. Correlation between inflammatory activation and neuronal markers may suggest a link between inflammation and release of markers of neuronal clinical and subclinical injury.
