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| Effects of Off-Pump and On-Pump Coronary Artery Bypass Grafting on Inflammatory Factors and Cardiac Function in Elderly Patients with Coronary Heart Disease Complicated with Valvulopathy |
| MA Dan, DU Xia, FENG Jianyu, et al |
| Xijing Hospital at the First Affiliated Hospital of Air Force Military Medical University, Shaanxi Xi'an 710032, China |
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Abstract Objective: To explore the effects of off-pump coronary artery bypass grafting (OPCABG) and on-pump coronary artery bypass grafting (ONCABG) on inflammatory factors and cardiac function in elderly patients with coronary heart disease (CHD) complicated with valvulopathy.Methods: The clinical data of 116 elderly patients with CHD complicated with valvulopathy who underwent coronary artery bypass grafting (CABG) between January 2015 and December 2017 were retrospectively analyzed.The patients were divided into OPCABG group (n=55) and ONCABG group (n=61) according to the surgical methods.The perioperative conditions (operative time, intraoperative blood transfusion volume, postoperative ventilator use time, postoperative hospital stay) were compared between the two groups, and the perioperative serum inflammatory factors [interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor α (TNF-α)] and cardiac function [cardiac troponin I (cTnI), creatine kinase (CK), creatine kinase isoenzyme (CK-MB)] were evaluated before operation and 1d and 3d after operation, and the incidence rate of postoperative complications was recorded in the two groups, and the incidence rates of major cardiovascular and cerebrovascular adverse events (MACE) were evaluated at 1 year of follow-up.Results: The operative time, intraoperative blood transfusion volume, postoperative ventilator use time and postoperative hospital stay in OPCABG group were all lower than those in ONCABG group (P<0.05).The inflammatory factors (IL-6, IL-8, TNF-α) and cardiac function (cTnI, CK, CK-MB) at 1d after operation and at 3d after operation were all increased first and then decreased (P<0.05), and the increases in OPCABG group were smaller than those in ONCABG group (P<0.05) while the decreases were greater than those in ONCABG group (P<0.05), and there were interaction effects between treatment methods and time of IL-6, IL-8 and TNF-α (P<0.05).In 1 year follow-up, there were no significant differences in the incidence rate of reoperation, cardiac death, myocardial infarction and stroke and total incidence rate of MACE between the two groups (P>0.05).Conclusion: OPCABG can improve perioperative status, postoperative inflammation and cardiac function in elderly patients with CHD complicated with valvulopathy, and it has similar prognosis with ONCABG.
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2020, Vol. 26 
