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Which Mechanism is Effective on the Hyperamylasaemia After Coronary Artery Bypass Surgery?

Halil Ibrahim Algin1, Ali Ihsan Parlar1, Ismail Yildiz2

  • 1Akut Kalp Damar Hospital, Department of Cardiovascular Surgery, İzmir, Turkey.

Heart, Lung & Circulation
|December 13, 2016
PubMed

Insights

Post-cardiac surgery, elevated amylase levels are common and linked to temporary kidney dysfunction. This hyperamylasemia after coronary artery bypass grafting (CABG) is primarily due to reduced amylase excretion, not clinical pancreatitis.

Area of Science:

  • Cardiology
  • Nephrology
  • Gastroenterology

Background:

  • Acute pancreatitis is a rare but lethal complication of cardiac surgery.
  • Hyperamylasemia occurs in 30-70% of patients post-coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).
  • The exact mechanism of pancreatic enzyme elevation after cardiac surgery remains unclear.

Purpose of the Study:

  • To investigate the relationship between temporary renal dysfunction and elevated pancreatic enzymes after CABG.
  • To determine the primary cause of post-CABG hyperamylasemia.

Main Methods:

  • Prospective study of 41 patients undergoing CABG with CPB.
  • Measurement of serum total amylase, phospholipase A2, macroamylase, Cystatin C, and urine NAG levels.

Main Results:

  • Hyperamylasemia observed in 88% of patients, peaking at 6 and 24 hours post-surgery.
  • All cases were asymptomatic isolated hyperamylasemia; no clinical pancreatitis developed.
  • Elevated Cystatin C and NAG levels indicated temporary renal damage.

Conclusions:

  • Amylase levels rise during extracorporeal circulation and peak postoperatively.
  • Reduced amylase excretion is the primary cause of hyperamylasemia following CABG.
  • Temporary renal dysfunction is associated with post-CABG hyperamylasemia.
Abstract

Keywords:
AmylaseCoronary artery bypass graftingCystatin CHyperamylasaemiaLipaseRenal dysfunction

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