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The effect of thiol-disulfide homeostasis in patients undergoing on-pump coronary artery bypass grafting
Umut Serhat Sanrı1, Kadir Kaan Özsin1, Faruk Toktaş1
1Department of Cardiovascular Surgery, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
Insights
Thiol-disulfide homeostasis shifts towards disulfide during on-pump coronary artery bypass grafting. Increased disulfide levels correlate with longer cross-clamp times and may predict postoperative atrial fibrillation.
Area of Science:
- Biochemistry
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Investigated thiol-disulfide homeostasis in patients undergoing on-pump coronary artery bypass grafting (CABG).
- Examined changes in thiol-disulfide balance during and after cardiac surgery.
Purpose of the Study:
- To assess the impact of on-pump CABG on thiol-disulfide homeostasis.
- To identify potential predictors of postoperative complications, specifically atrial fibrillation.
Main Methods:
- Studied 51 patients undergoing on-pump CABG between January and October 2018.
- Measured thiol-disulfide homeostasis parameters at preoperative, intraoperative (T2), and postoperative (T3) time points.
- Evaluated hemodynamic parameters including atrial fibrillation and inotropic support requirements.
Main Results:
- Significant alterations in thiol-disulfide homeostasis parameters were observed across surgical time points (p<0.001).
- The disulfide/native thiol ratio at T2 independently predicted postoperative atrial fibrillation (p=0.042).
- Elevated T2-disulfide levels correlated positively with cross-clamp duration (r=0.307, p=0.029).
Conclusions:
- On-pump CABG induces a shift in thiol-disulfide homeostasis towards increased disulfide levels.
- Prolonged ischemia time is associated with rising disulfide levels.
- Reduced native thiol and elevated disulfide during ischemia may serve as predictors for postoperative atrial fibrillation.
Background:
In this study, we aimed to investigate the effects of thiol-disulfide homeostasis in patients undergoing on-pump coronary artery bypass grafting.
Methods:
Between January 2018 and October 2018, a total of 51 patients (43 males, 8 females; mean age 61.8±8.7 years; range, 38 to 78 years) who underwent isolated on-pump coronary artery bypass grafting were included. Thiol-disulfide homeostasis parameters were studied in the preoperative period (T1), 30 min after the removal of cross-clamp (T2), and postoperative sixth h (T3). Hemodynamic parameters such as atrial fibrillation and inotropic support requirement of the patients were evaluated in the postoperative period.
Results:
There were significant differences in the measured thiol-disulfide homeostasis parameters at different time points of surgery (p<0.001). Binary logistic regression analysis showed that T2-disulfide/native thiol ratio was an independent predictor of the development of postoperative atrial fibrillation (p=0.042). There were positive and significant correlations between the T2-disulfide levels and cross-clamp time (r:0.307, p=0.029).
Conclusion:
Thiol-disulfide homeostasis in patients undergoing on-pump coronary artery bypass grafting changes toward to disulfide. Disulfide levels increase in parallel with prolonged ischemia time. Decreased native thiol and increased disulfide levels during ischemic period may be predictive of postoperative atrial fibrillation.
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