Edorium Journal of

Cardiothoracic and Vascular Surgery

 
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Creatine phosphokinase did not increase after on-pump beating heart coronary artery bypass graft early after acute myocardial infarction
Tamaki Takano1, Takamitsu Terasaki1, Yoshinori Ohtsu2, Yuko Wada2, Tatsuichiro Seto2, Daisuke Fukui2
1MD, Nagano Red Cross Hospital, Department of Cardiovascular Surgery, Wakasato, Nagano, Japan.
2MD, Shinshu University School of Medicine, Department of Cardiovascular Surgery, Asahi, Matsumoto, Japan.

Article ID: 100007C04TT2015
doi:10.5348/C04-2015-7-OA-6

Address correspondence to:
Tamaki Takano
MD, Nagano Red Cross Hospital, Department of Cardiovascular Surgery
5-22-1 Wakasato
Nagano 380-8582
Japan
Fax: +81-26-224-1065

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How to cite this article
Takano T, Terasaki T, Ohtsu Y, Wada Y, Seto T, Fukui D. Creatine phosphokinase did not increase after on-pump beating heart coronary artery bypass graft early after acute myocardial infarction. Edorium J Cardiothorac Vasc Surg 2015;2:30–35.


Abstract
Aims: Emergency coronary artery bypass grafting (CABG) is sometimes mandatory although operative mortality is high within 24 hours after the onset of acute myocardial infarction (AMI). We have used on-pump beating heart (OPBH) CABG to reduce injury to non-infarcted myocardium during CABG. We compared clinical outcomes of OPBH with those of conventional CABG with cardiac arrest (OPCA), both performed within 24 hours after the onset of AMI.
Methods: Twenty-two patients were enrolled in this study. Patients' basic characteristics, operative procedure, in-hospital mortality, morbidity and changes in creatine phosphokinase (CPK) and myocardial subset of CPK (creatine phosphokinase-myoglobin binding, CPK-MB) and ejection fraction (EF) were retrospectively obtained by reviewing hospital records.
Results: In the OPCA group, postoperative increases were seen in mean CPK (p=0.03) and in CPK-MB (p=0.03). In the OPBH group, postoperative decreases were seen in mean CPK (p=0.43) and in CPK-MB (p=0.07). Ejection fraction increased postoperatively in both groups, although the increase in OPCA was not significant. No statistically significant differences were found in mortality and morbidity between OPCA and OPBH.
Conclusion: In our study, OPBH did not increase CPK and CPK-MB in early AMI treatment, suggesting that OPBH may reduce myocardial injury during CABG performed very early after AMI although further studies including randomized trial are warranted.

Keywords: Acute myocardial infarction, Beating heart, Coronary artery bypass graft, Creatine phosphokinase


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Author Contributions:
Tamaki Takano – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Takamitsu Terasaki – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Yoshinori Ohtsu – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Yuko Wada – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Tatsuichiro Seto – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Daisuke Fukui – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Tamaki Takano et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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