Ischemia-modified albumin reduction after coronary bypass surgery is associated with the cardioprotective efficacy of cold-blood cardioplegia enriched with N-acetylcysteine: a preliminary study.

Abstract

BACKGROUND:

The aims of this preliminary study were to determine the alteration of serum ischemia-modified albumin (IMA) levels and to investigate whether IMA may be used as an indicator of the cardioprotective efficacy of N-acetylcysteine (NAC) in patients undergoing coronary bypass grafting (CABG).

PATIENTS AND METHODS:

Forty-four patients were randomized into one of two groups on the basis of cardioplegic strategies, either cold-blood cardioplegia enriched with NAC (50 mg/kg) or cold-blood cardioplegia alone. Serum IMA, cardiac troponin T (cTnT) and malondialdehyde (MDA) levels determined in NAC-enriched patients before and after CABG were compared with those of the NAC-free group. The albumin cobalt binding assay was used for IMA determination.

RESULTS:

Serum IMA levels were significantly elevated after cross-clamping and peaked at 6 h after reperfusion in the two groups. In NAC-enriched patients, IMA levels determined 6, 12, 24 and 48 h after reperfusion were significantly lower than those of the NAC-free group (p < or = 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). IMA returned to baseline 24 h after reperfusion differently from cTnT and MDA in the NAC-enriched group.

CONCLUSIONS:

IMA may be used as not only an indicator of myocardial ischemia-reperfusion injury, but also as a useful indicator of the cardioprotective effect of NAC in CABG.

• Authors: S Caner Karahan, Ismail Koramaz, Gokalp Altun, Utku Uçar, Murat Topbaş, Ahmet Menteşe, Muge Kopuz
• Journal: European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes (Eur Surg Res) Vol. 44 Issue 1 Pg. 30-6 ( 2010) ISSN: 1421-9921 [Electronic] Switzerland
• PMID: 19955769 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright 2009 S. Karger AG, Basel.

Chemical References

• Albumins
• Cardiotonic Agents
• Troponin T
• Malondialdehyde
• Acetylcysteine

Topics

• Acetylcysteine (therapeutic use)
• Albumins (metabolism)
• Cardiotonic Agents (therapeutic use)
• Cold Temperature
• Coronary Artery Bypass (adverse effects)
• Female
• Heart Arrest, Induced (adverse effects)
• Humans
• Male
• Malondialdehyde
• Middle Aged
• Myocardial Reperfusion Injury (blood, etiology, prevention & control)
• Troponin T (blood)