Myocardial Cellular Damage and Antioxidant Status in Off-Pump Versus On-Pump Coronary Artery Bypass Grafting - A Prospective Study

Coronary artery bypass grafting (CABG) is usually performed with cardiopulmonary bypass (CPB). The offpump CABG technique is an alternative to the standard on-pump technique. The purpose of this study was to evaluate myocardial cell damage and antioxidant status in off-pump and on-pump CABG. Patients (30 men and 15 women) undergoing CABG were included. The off-pump technique was used in 25 patients (mean age 59 ± 10 years). The on-pump technique was used in 20 patients (mean age of 57 ± 11 years). Tissue injury markers [e.g. creatine kinase (CK), CK-MB isoenzyme and cardiac troponin-I (cTnI)] and antioxidant markers [e.g. glutathione peroxidase (GPx), superoxide dismutase (SOD) and malondialdehyde (MDA)] were measured before and 1, 6, 24, 48 and 72h postoperatively. The levels of CK, CK-MB after the on-pump technique were significantly higher when compared to after off-pump CABG (p<0.001). cTnI levels followed the same pattern (p<0.001). MDA levels after on-pump CABG were higher than after off-pump CABG (p<0.001). These findings suggest that off-pump CABG causes less myocardial injury than the on-pump technique.