Microplegia versus Cardioplexol® in Coronary Artery Bypass Surgery with Minimal Extracorporeal Circulation: Comparison of Two Cardioplegia Concepts.
- Koechlin L Department of Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.
- Rrahmani B Department of Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.
- Gahl B Department of Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.
- Berdajs D Department of Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.
- Grapow MTR Department of Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.
- Eckstein FS Department of Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.
- Reuthebuch O Department of Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.
- 2019-04-26
Published in:
- The Thoracic and cardiovascular surgeon. - 2020
Aged
Biomarkers
Cardioplegic Solutions
Cardiopulmonary Bypass
Coronary Artery Bypass
Creatine Kinase, MB Form
Female
Heart Arrest, Induced
Humans
Intensive Care Units
Length of Stay
Male
Middle Aged
Myocardial Reperfusion Injury
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Troponin T
English
BACKGROUND
The aim of this study is to compare the combined use of the Myocardial Protection System and our microplegia (Basel Microplegia Protocol) with Cardioplexol® in coronary artery bypass grafting using the minimal extracorporeal circulation.
METHODS
The analysis focused on propensity score matched pairs of patients in whom microplegia or Cardioplexol® was used. Primary efficacy endpoints were high-sensitivity cardiac troponin-T on postoperative day 1 and peak values during hospitalization. Furthermore, we assessed creatine kinase and creatinine kinase-myocardial type, as well as safety endpoints.
RESULTS
A total of 56 patients who received microplegia and 155 patients who received Cardioplexol® were included. The use of the microplegia was associated with significantly lower geometric mean (confidence interval) peak values of high-sensitivity cardiac troponin-T (233 ng/L [194-280 ng/L] vs. 362 ng/L [315-416 ng/L]; p = 0.001), creatinine kinase (539 U/L [458-633 U/L] vs. 719 U/L [645-801 U/L]; p = 0.011), and creatinine kinase-myocardial type (13.8 µg/L [9.6-19.9 µg/L] vs. 21.6 µg/L [18.9-24.6 µg/L]; p = 0.026), and a shorter length of stay on the intensive care unit (1.5 days [1.2-1.8 days] vs. 1.9 days [1.7-2.1 days]; p = 0.011). Major adverse cardiac and cerebrovascular events occurred with roughly equal frequency (1.8 vs. 5.2%; p = 0.331).
CONCLUSIONS
The use of the Basel Microplegia Protocol was associated with lower peak values of high-sensitivity cardiac troponin-T, creatinine kinase, and creatinine kinase-myocardial type and with a shorter length of stay on the intensive care unit, as compared with the use of Cardioplexol® in isolated coronary artery bypass surgery using minimal extracorporeal circulation.
The aim of this study is to compare the combined use of the Myocardial Protection System and our microplegia (Basel Microplegia Protocol) with Cardioplexol® in coronary artery bypass grafting using the minimal extracorporeal circulation.
METHODS
The analysis focused on propensity score matched pairs of patients in whom microplegia or Cardioplexol® was used. Primary efficacy endpoints were high-sensitivity cardiac troponin-T on postoperative day 1 and peak values during hospitalization. Furthermore, we assessed creatine kinase and creatinine kinase-myocardial type, as well as safety endpoints.
RESULTS
A total of 56 patients who received microplegia and 155 patients who received Cardioplexol® were included. The use of the microplegia was associated with significantly lower geometric mean (confidence interval) peak values of high-sensitivity cardiac troponin-T (233 ng/L [194-280 ng/L] vs. 362 ng/L [315-416 ng/L]; p = 0.001), creatinine kinase (539 U/L [458-633 U/L] vs. 719 U/L [645-801 U/L]; p = 0.011), and creatinine kinase-myocardial type (13.8 µg/L [9.6-19.9 µg/L] vs. 21.6 µg/L [18.9-24.6 µg/L]; p = 0.026), and a shorter length of stay on the intensive care unit (1.5 days [1.2-1.8 days] vs. 1.9 days [1.7-2.1 days]; p = 0.011). Major adverse cardiac and cerebrovascular events occurred with roughly equal frequency (1.8 vs. 5.2%; p = 0.331).
CONCLUSIONS
The use of the Basel Microplegia Protocol was associated with lower peak values of high-sensitivity cardiac troponin-T, creatinine kinase, and creatinine kinase-myocardial type and with a shorter length of stay on the intensive care unit, as compared with the use of Cardioplexol® in isolated coronary artery bypass surgery using minimal extracorporeal circulation.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1055/s-0039-1687843
- PMID 31022735
- Persistent URL
- https://sonar.ch/global/documents/251914
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