[Aprotinin reduces myocardial injury in the off-pump coronary artery bypass grafting].

Zhonghua Yi Xue Za Zhi

Department of Cardiac Surgery, Peking University First Hospital, Beijing 100034, China.

Published: December 2003

Objective: To investigate the effect of aprotinin on the myocardial injury during the off-pump coronary artery bypass grafting (OPCAB).

Methods: Twenty-four patients undergoing OPCAB randomly were of 12 patients divided into two groups: aprotinin group and Control group (n = 12). In the aprotinin group a loading dose (2 x 10(6) KIU) was administered within the first 30 minutes after the induction followed by continuous infusion of 0.5 x 10(6) KIU/h throughout the operation. The plasma myocardial injury markers CK-MB and cTnI were measured at the four points: (1) After induction; (2) 1 hour after coronary anastomosis; (3) 6 hours and (4) 24 hours after the operation. The blood loss was recorded by autotransfusion in the operation, and the drainage immediately, 6 hours, and 24 hours after the operation.

Result: Myocardial injury markers CK-MB and cTnI increased significantly after the anastomosis in each group; cTnI was lower in the aprotinin group than in the control group at the third and forth points (P < 0.05). The post-operative drainage after 6 hours and 24 hours were lower in the aprotinin group than in control group (P < 0.05).

Conclusions: There is the myocardial injury during OPCAB. Aprotinin can reduce the myocardial injury during OPCAB.

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