Statin reload before off-pump coronary artery bypass graft: Effect on biomarker release kinetics
| العنوان: | Statin reload before off-pump coronary artery bypass graft: Effect on biomarker release kinetics |
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| المؤلفون: | Surendra K Agarwal, Shiridhar Kashyap, Aditya Kapoor, Atul Kaushik, Pravin K. Goel, Sudeep Kumar, Gauranga Majumdar, Shantanu Pande, Prabhat Tewari, Naveen Garg, Archana Sinha, Satyendra Tewari, Roopali Khanna |
| المصدر: | Annals of Cardiac Anaesthesia, Vol 23, Iss 1, Pp 27-33 (2020) Annals of Cardiac Anaesthesia |
| بيانات النشر: | Wolters Kluwer Medknow Publications, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Statin, off-pump, medicine.drug_class, medicine.medical_treatment, Ischemia, 030204 cardiovascular system & hematology, Loading dose, lcsh:RD78.3-87.3, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Internal medicine, Natriuretic Peptide, Brain, Preoperative Care, Troponin I, medicine, Humans, cardiovascular diseases, statin reload, Rosuvastatin Calcium, Creatine Kinase, Off-pump coronary artery bypass, biology, business.industry, biomarkers, General Medicine, Perioperative, Middle Aged, medicine.disease, Troponin, coronary artery bypass, Kinetics, Anesthesiology and Pain Medicine, lcsh:Anesthesiology, lcsh:RC666-701, Reperfusion Injury, biology.protein, Cardiology, Biomarker (medicine), Female, Original Article, Creatine kinase, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Objectives: Statins confer protection from ischemia/reperfusion through various pathways including pleiotropic mechanisms. Following chronic administration, activation of intrinsic cellular mechanisms causes attenuation of these pleiotropic effects. Methods: Since coronary artery bypass surgery (CABG) represents a reversible ischemia-reperfusion sequence, we assessed if statin reload is effective in patients undergoing off-pump CABG (n = 100) in limiting myocardial injury. Patients received loading dose of rosuvastatin (40 mg initiated 7 days before surgery) while nonloaded patients continued whatever statin dose they were receiving and served as controls. Cardiac biomarkers (Troponin-I, creatine kinase muscle/brain [CK-MB], and B-type natriuretic peptide [BNP]) were measured at 8, 24, and 48 h postoperatively. The primary end-point was the extent of perioperative myocardial injury (area under the curve [AUC]: AUC of each biomarker). Results: Despite similar baseline levels, all biomarkers at 8, 24, and 48 h were significantly lower in the loaded group. The AUC for each biomarker was also significantly lower in the loaded group (cTnI 37.96 vs. 70.12 ng. hr/ml, CK-MB 229.64 vs. 347.04 ng. hr/ml, and BNP 5257.56 vs. 15606.68 pg. hr/ml, all P < 0.001). Delta cTnI (change from baseline to peak level) (1.00 ± 1.34 vs. 2.25 ± 2.59), delta CK-MB (4.54 ± 5.89 vs. 10.68 ± 9.95), and delta BNP (120.41 ± 172.48 vs. 449.23 ± 790.95) all P < 0.001 were also significantly lower in the loaded group. Those loaded with rosuvastatin had lower inotrope duration (22.9 ± 23.33 vs. 31.26 ± 25.39 h, P = 0.04) and ventilator support time (16.94 ± 6.78 vs. 23.8 ± 20.53 h, P = 0.03). Conclusion: In patients undergoing off-pump CABG, statin reload can “recapture” cardioprotection in patients already on statins with favorable effect on release kinetics of biomarkers and postoperative outcomes. |
| اللغة: | English |
| تدمد: | 0971-9784 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5208b18d16c4435c19bc1aecec1c2125 http://www.annals.in/article.asp?issn=0971-9784;year=2020;volume=23;issue=1;spage=27;epage=33;aulast=Kaushik |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....5208b18d16c4435c19bc1aecec1c2125 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 09719784 |
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