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Journal of Cardiovascular Medicine and Surgery

Volume  6, Issue 1, January-March 2020, Pages 18-23
 

Original Article

Effect of Off-Pump Coronary Artery Bypass Surgery on C-Reactive Protein Level

Jayita Chakrabarti, Subhendu Sekhar Mahapatra, Ratan Mondal,

1 Assistant Professor 2 Associate Professor, Department of Cardiothoracic and Vascular Surgery (CTVS), Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal 700020, India. 3 OT Technician, Department of CTVS, Nightingale Hospital, Kolkata, West Bengal 700020, India.

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.6120.3

Abstract

Context: Off-Pump Coronary Artery Bypass Surgery (OPCAB) induces schaemic injury of varying degree. The inflammation associated with such ischaemia causes rise in CRP level. Heart failure is an important consequence of OPCAB in immediate postoperative (postop) period and may affect overall recovery.

Aims: Our study investigated a relationship between CRP level and parameters of heart failure in postoperative period, so that, CRP level can guide us to predict the prognosis of such patients. Settings and Design: This is a retrospective study done on the population of eastern India with ischaemic heart disease, underwent OPCAB from January 2018 to June 2019. 83 male patients were selected depending on various exclusion criteria including abnormal lung function. All patients were investigated for preoperative cardiac, renal, liver and haematological parameters along with assesment of preoperative (preop) CRP level.

Materials and Methods: 44 patients (pts) were seen to have normal CRP level preoperatively. These pts in postoperative day one (POD 1) were checked for CRP level and were divided into two groups, ≥10 miligram/litre (mg/L) and < 10 mg/L. Other postoperative investigations on various organ system were done. Statistical analysis used: Two sample t-tests for a difference in mean involved independent samples or unpaired samples. p value less than or equal to 0.05 was considered statistically significant.

Results: Heart failure parameters like brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and Left Ventricular End Systolic Volume (LVESV), postoperative ventilation time and hospital stay were significantly increased in the group having ≥ 10 mg/L CRP.

Conclusion: High CRP level in postoperative OPCAB patients has a predictive power as good as LVEF and LVESV. It can guide us regarding overall recovery.

 


Keywords : CRP; Heart failure; Ischaemic injury; OPCAB, Prognosis.
Corresponding Author : Subhendu Sekhar Mahapatra