Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery

Systemic inflammatory response and myocardial damage following coronary artery bypass graftingwith or without cardiopulmonary bypass in low-risk patients

Authors: L.A. Bockeria, V.Yu. Merzlyakov, D.Sh. Samuilova, I.V. Klyuchnikov, L.S. Selimyan, M.F. Abadzhyan, A.A. Rakhimov, A.V. Kazaryan

A.N. Bakoulev Scientific Center for Cardiovascular Surgery of the Russian Academy of Medical Sciences

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Link: Clinical Physiology of Blood Circulaiton. 2014; (): -

Quote as: Bockeria L.A., Merzlyakov V.Yu., Samuilova D.Sh., at al. Systemic inflammatory response and myocardial damage following coronary artery bypass grafting with or without cardiopulmonary bypass in low-risk patients. Klinicheskaya Fiziologiya Krovoobrashcheniya. 2014; 1: 52–59.

Full text:  


Objective – to analyze the development of systemic inflammatory response (SIR) and the myocardial damage in patients at low risk of coronary artery bypass grafting (CABG) with and without cardiopulmonary bypass (CBP) in order to determine the extent of the contribution of CPB and aortic cross-clamping in the development of SIR in CABG.

Material and methods.
The study included 41 patients with ischemic heart disease. Depending on the nature of the surgery, the patients were divided into two groups. CABG on the beating heart was performed in patients in Group 1 (n = 21). Group 2 included 20 patients who underwent CABG with CBP. All patients underwent median sternotomy. Prior to surgery, and in the dynamics of post-operative period for monitoring the perioperative myocardial injury were studied cardiac troponin I (cTnI) and MB fraction of creatine kinase (CK-MB) levels, to evaluate the postoperative systemic inflammatory response – the values of serum IL-6 and high-sensitivity C-reactive protein (hs-CRP).

On the first post-operative day (POD) the cTnI levels were statistically different (p < 0.05) between the two groups and were 3 (1; 5) and 6 (2; 15) ng/ml in groups 1 and 2, respectively. On POD 3 and 7 the levels cTnI were lower and were comparable between two groups (p > 0.05). The CK-MB levels on POD 1 were lower in the first group compared to the second group, however the difference was not statistically significant (13 (12; 19) and 18 (12; 29) ng/ml, p > 0.05). The IL-6 and hs-CRP was comparable between two groups at all time points (p > 0.05).

CABG with CPB is associated with more severe myocardial injury compared to CABG without CPB. The main impetus for the development of SIR in low-risk patients is surgical trauma. The effect of ECC on the acute phase of inflammation is less significant.


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