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On-line Access: 2018-09-04

Received: 2017-11-08

Revision Accepted: 2018-04-25

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Journal of Zhejiang University SCIENCE B 2018 Vol.19 No.9 P.735-738

http://doi.org/10.1631/jzus.B1700553


Three-vessel coronary artery disease may predict changes in biochemical brain injury markers after off-pump coronary artery bypass grafting#


Author(s):  Wojciech Pawliszak, Krzysztof Szwed, Artur Słomka, Natalia Piekuś-Słomka, Magdalena Szwed, Mariusz Kowalewski, Ewa Żekanowska, Alina Borkowska

Affiliation(s):  Department of Cardiac Surgery, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-635 Bydgoszcz, Poland; more

Corresponding email(s):   artur.slomka@cm.umk.pl

Key Words:  Cardiac surgery, Coronary artery disease, Glial fibrillary acidic protein, Neuroserpin, Phosphorylated axonal neurofilament subunit H


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Wojciech Pawliszak, Krzysztof Szwed, Artur Słomka, Natalia Piekuś-Słomka, Magdalena Szwed, Mariusz Kowalewski, Ewa Żekanowska, Alina Borkowska. Three-vessel coronary artery disease may predict changes in biochemical brain injury markers after off-pump coronary artery bypass grafting#[J]. Journal of Zhejiang University Science B, 2018, 19(9): 735-738.

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author="Wojciech Pawliszak, Krzysztof Szwed, Artur Słomka, Natalia Piekuś-Słomka, Magdalena Szwed, Mariusz Kowalewski, Ewa Żekanowska, Alina Borkowska",
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%A Magdalena Szwed
%A Mariusz Kowalewski
%A Ewa Żekanowska
%A Alina Borkowska
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A1 - Natalia Piekuś-Słomka
A1 - Magdalena Szwed
A1 - Mariusz Kowalewski
A1 - Ewa Żekanowska
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Abstract: 
Neurological injury is a frequent and important complication of coronary artery bypass grafting (CABG). Several risk factors for this type of sequela have been identified, among them aortic arch atherosclerosis. Our previous study indicated that atherosclerotic burden in coronary arteries may likewise predict postoperative neurological complications (Pawliszak et al., 2016b). We assessed the severity of this condition by using the SYNTAX score calculator. However, diagnosing angiographic three-vessel coronary artery disease (3VD) could be an even simpler method of achieving this goal.

三支冠脉病变可预测非体外循环下冠状动脉旁路移植手术后颅脑损伤生化标志物的变化

目的:研究冠状动脉旁路移植手术(CABG)后患者的胶质纤维酸性蛋白(GFAP)、神经源性丝氨酸蛋白酶抑制素(NSP)及磷酸化轴突神经丝亚基H(PNFH)水平与三支冠脉病变(3VD)的相关性.
方法:招募计划进行CABG的60~70岁病人作为研究对象,根据术前冠状动脉造影显示是否患有3VD分为两组.排除患有精神疾病、做过心脏手术或心血管成形手术以及左室射血分数≤30%和(或)颈动脉狭窄率≥70%的病人.
结论:在本研究中,术后3VD组患者的GFAP、NSP和PNFH水平存在统计学上的显著变化,而非3VD组患者仅在NSP水平上出现统计学上的显著变化.同时发现,3VD患者在非体外循环CABG后颅脑损伤生化标志物的水平变化比没有3VD的患者更明显.

关键词:三支冠脉病变;磷酸化轴突神经丝亚基H;胶质纤维酸性蛋白;神经源性丝氨酸蛋白酶抑制素;血管造影诊断

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Luger S, Witsch J, Dietz A, et al., 2017. Glial fibrillary acidic protein serum levels distinguish between intracerebral hemorrhage and cerebral ischemia in the early phase of stroke. Clin Chem, 63(1):377-385.

[2]Pawliszak W, Kowalewski M, Raffa GM, et al., 2016a. Cerebrovascular events after no-touch off-pump coronary artery bypass grafting, conventional side-clamp off-pump coronary artery bypass, and proximal anastomotic devices: a meta-analysis. J Am Heart Assoc, 5(2):e002802.

[3]Pawliszak W, Szwed K, Szwed M, et al., 2016b. Predictive value of the SYNTAX score for short-term cognitive outcomes after off-pump coronary artery bypass surgery. Int J Cardiol, 209:9-11.

[4]Rodríguez-González R, Sobrino T, Rodríguez-Yáñez M, et al., 2011. Association between neuroserpin and molecular markers of brain damage in patients with acute ischemic stroke. J Transl Med, 9:58.

[5]Singh P, Yan J, Hull R, et al., 2011. Levels of phosphorylated axonal neurofilament subunit H (pNfH) are increased in acute ischemic stroke. J Neurol Sci, 304(1-2):117-121.

[6]Szwed K, Pawliszak W, Anisimowicz L, et al., 2014. Short-term outcome of attention and executive functions from aorta no-touch and traditional off-pump coronary artery bypass surgery. World J Biol Psychiatry, 15(5):397-403.

[7]Szwed K, Pawliszak W, Serafin Z, et al., 2017. CArbon dioxide surgical field flooding and aortic NO-touch off-pump coronary artery bypass grafting to reduce Neurological injuries after surgical coronary revascularisation (CANON):protocol for a randomised, controlled, investigator and patient blinded single-centre superiority trial with three parallel arms. BMJ Open, 7(7):e016785.

[8]List of electronic supplementary materials

[9]Fig. S1 Serum levels of GFAP before surgery in patients stratified by sex and comorbidities

[10]Fig. S2 Serum levels of NSP before surgery in patients stratified by sex and comorbidities

[11]Fig. S3 Serum levels of PNFH before surgery in patients stratified by sex and comorbidities

[12]Table S1 Correlations of preoperative GFAP, NSP, and PNFH serum levels with clinical parameters in whole cohort and in the non-3VD and 3VD groups

[13]Table S2 Comparison of median or mean levels of GFAP among healthy controls

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