Effect of creatine kinase isoenzyme (CK-MB) on early prognosis after off-pump coronary artery bypass grafting.
Efecto de la isoenzima de creatina quinasa (CK-MB) en el pronóstico temprano después de un injerto de revascularización coronaria sin circulación extracorpórea.
Abstract
This study aimed to analyze the effect of elevated creatine kinase isozyme levels on early prognosis after off-pump coronary artery bypass (OPCAB) grafting. Based on the levels of creatine kinase isoenzyme (CK- MB), 116 patients were divided into two groups: one with a mild increase (n=85) and another group with a severe increase (n=31) in the enzyme. Clinical data, changes in CK-MB levels at 12, 24, and 48 hours after surgery, changes in left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVESD) before surgery, and seven days and three months after surgery were measured, and recorded. Also, the blood flow of the bridging vessel, vascular resistance, the diameter of the anterior descending branch, and the diameter of the distal target vessel were recorded during the operation (> 1.5 mm). A decrease in the level of LVEDD was recorded in both groups after the operation compared to the levels before. However, in the group with a mild increase in CK-MB, the LVEF after the operation increased compared to before the operation (p<0.05). The occurrence of angina pectoris 24 hours before surgery, high vascular resistance during surgery, and diameter of distal target vessel > 1.5 mm were related factors affecting the increase of CK-MB after surgery. The ratio of these factors was higher in the severe increase group than in the mild increase group (p<0.05). An increase in myocardial enzymes causes a slow recovery of myocardial function, so it can be used as a critical biological index to reflect the prognosis of patients.
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