[Comparative Clinical Biochemical Assessment of the State of Myocardium After Coronary Artery Bypass Surgery...

We compared parameters of the state of myocardium after coronary artery bypass surgery (CABS) performed according to the following techniques - with complete cardiopulmonary bypass (CABS-CBP), beating heart bypass grafting with parallel normothermic perfusion (CABS-BH-NP), and beating heart bypass grafting (CABS-BH). Patients (n=100, 86% men, 14% women, age 56-69 years) were divided into 3 groups with comparable sex, age, state of the myocardium, and EUROSCORE surgical risk. In group 1 patients (n=35) we used CABS-CHB, in group 2 (n=32) - CABS-BH-NP, in group 3 (n=33) - CABS-BH. The following parameters were obtained on day 1 after surgery: left ventricular ejection fraction (EF, echocardiography), blood plasma levels of creatine phosphokinase (CPK), CPK-MB, and cardiac troponin I (TnI). There was no significant difference in parameters studied between groups 1 and 2 with a tendency to their more pronounced positive dynamics in group 2. In group 3 compared with groups 1 and 2 we observed significant lowering of levels of CPK (by 21.2-30.9%, p<0.05), CPK-MB (by 9.1-13.1%, p<0.05), TnI (by 0.6-0.7%, p<0.05), and elevation of EF (by 9.8-11.6%, p<0.05). Rate of development of myocardial infarction in group 3 (6.8%) was lower than in groups 1 and 2 (14.2 and 9.8%, respectively). In all groups we observed close correlation between biochemical parameters and left ventricular EF (r=0.74-0.82, p<0.01).