[Protection of ulinastatin against myocardial injury induced by off-pump coronary artery bypass graft surgery: report of 24 cases].

Objective: To investigate the protective effect of ulinastatin against myocardial injury induced by off-pump coronary artery bypass graft surgery (OPCAB).

Methods: Twenty-four patients undergoing OPCAB were randomly divided into 2 equal groups: ulinastatin group in which ulinastatin was infused intravenously, firstly at the concentration of 6000 U/kg dissolved in 50 ml normal saline for 30 min and then at the speed of 1000 U.kg(-1).h(-1) up to the end of operation, and control group that underwent infusion of normal saline of the same volume. Blood samples were collected before skin incision, 0.5 h after the completion of vascular anastomosis, and 2, 6, and 18 h after the operation to detect the plasma level of cardiac troponin 1 (cTn1).

Results: The cTn1 levels 2, 6, and 18 h after the operation of both groups were all significantly higher than those before skin incision (all P < 0.01). The cTn1 levels 0.5 h after the completion of vascular anastomosis, and 2, 6, and 18 h after the operation of the ulinastatin group were all significantly lower than those of the control group (all P < 0.01).

Conclusion: Ulinastatin decreases the cTn1 level that increases peri-operatively, thus reducing the risk of myocardial injury in patients undergoing OPCAB.