Koroner Arter Bypass Cerrahisinde Serum Iskemi Modifiye Albumin Duyarlılığı

Abstract

AIM: Determination of new biochemical indicators may contribute to the early diagnosis and treatment of myocardial injury which is frequently seen after cardiovascular surgical procedures. Moreover early detection of such ischemic events particularly after termination of extracorporeal circulation should permit life saving interventions. The studies conducted in recent years have proved occurrence of some alterations in albumin conformation during myocardial ischemic events and they suggested ischemia modified albümin (IMA) as a new cardiac biomarker in ischemia. In this study we aimed to investigate the value of serum ischemia modified albumin in follow up of perioperative and postoperative ischemic events of coronary arterial bypass surgery patients. We also aimed to compare its sensitivity with other well known markers such as CK-MB and troponine I. MATERIAL AND METHOD: 45 patients whom were performed coronary arterial bypass surgery in Hacettepe University Medical Faculty Cardiovascular Surgery department between 07.02.2014 and 01.05.2014 participated in the study. Blood samples were collected in sequence of preoperative, postoperative 0. hour, postoperative 4th hour, 24th hour and 96th Hour. Measurements of IMA, CK-MB and troponine I were performed and compared from these samples. RESULTS: According to comparisons of 45 patients whom were performed coronary arterial bypass surgery, there were statistically significant differences between IMA levels regarding preoperative and postoperative 0. hour. IMA levels were concurrently increased with ischemic events which developed after CPB. By the revascularization of myocardial tissue, IMA levels exhibited a decrease that reached to basal levels by the postoperative 4th hour. These findings were congruent with the literature. CONCLUSION: IMA levels may increase soon after ısolated coronary bypass operations Moreover the rise of IMA occurs more rapidly and reach to peak levels when compared to CK-MB and troponine I markers. Likely in the future a multimarker strategy which involve miyoglobin, İMA, CK-MB, troponines and CRP will be the best approach for early diagnosis and treatment of myocardial ischemia.