Off-pump CABG reduces complement activation but does not significantly affect peripheral endothelial function: a prospective randomized study.

• OBJECTIVE--Cardiac surgery initiates a systemic inflammatory response, which may affect endothelial function. The aim of this study was to investigate if off-pump CABG (OPCAB) reduces the postoperative inflammatory response and affects endothelial function less than conventional on-pump CABG. DESIGN--Fifty-two patients submitted for elective CABG were included in a prospective, randomized study. Twenty-six patients were operated with, and 26 without cardiopulmonary bypass (CPB). Plasma levels of complement (C3a), cytokines (IL-8, TNF-alpha), endothelin-1 and neopterin were measured before and during surgery and 2 and 24 h after surgery. Endothelial function was assessed by forearm plethysmography and acetylcholine infusion in 30 patients 2-4 h after surgery. RESULTS--C3a and neopterin concentrations were significantly higher during and early after surgery in the CPB group while TNF-alpha and IL-8 tended to be higher in the CPB group but the difference did not reach statistical significance. Endothelial function did not differ significantly between the two groups. CONCLUSION--OPCAB reduces complement activation compared with on-pump CABG but does not significantly affect TNF-alpha and IL-8 release or endothelial function.

Nyckelord

Acetylcholine

administration & dosage

Area Under Curve

Biological Markers

blood

Cardiopulmonary Bypass

Complement Activation

drug effects

physiology

Complement C3a

drug effects

metabolism

Coronary Artery Bypass

Dose-Response Relationship

Drug

Endothelin-1

blood

drug effects

Endothelium

Vascular

metabolism

physiopathology

surgery

Female

Forearm

blood supply

Humans

Interleukin-8

blood

Male

Middle Aged

Neopterin

blood

Nitroprusside

administration & dosage

Prospective Studies

Regional Blood Flow

drug effects

physiology

Treatment Outcome

Tumor Necrosis Factor-alpha

drug effects

metabolism

Vasodilation

drug effects

physiology

Vasodilator Agents

administration & dosage

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