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Malondialdehyde in plasma, a biomarker of global oxidative stress during mini-CABG compared to on- and off-pump CABG surgery: a pilot study

^a Department of Clinical Chemistry, Sint Antonius Hospital, Koekoekslaan 1, P.O. Box 2500, 3430 EM Nieuwegein, The Netherlands
^b Cardiothoracic Surgery, Sint Antonius Hospital, Nieuwegein, The Netherlands
^c Anesthesiology, Sint Antonius Hospital, Nieuwegein, The Netherlands
^d Department of Anaesthesia, University Medical Center Groningen, Groningen, The Netherlands

*Corresponding author. Tel.: +31-30-6099111 pager 687; fax: +31-30-6092528.

E-mail address: w.gerritsen{at}antonius.net (W.B. Gerritsen).

In contrast to conventional on-pump coronary artery bypass grafting only mild increase of parameters of oxidative stress is reported during and after off-pump coronary artery bypass grafting. In an attempt to reduce the side effects of extra corporeal circulation the mini- extra corporeal circulation concept was introduced. In this study peroperative oxidative stress biomarkers were compared using three different techniques for CABG (conventional, mini and off-pump). It concerns a prospective randomized pilot study of 60 aged patients (70+ years) divided over 3 study groups. During the peroperative time points there was a significant increase in the mean concentration of uric acid for the CCABG group. On arrival at the intensive care unit the mean concentrations decreased significantly. During the per-operative period all groups showed significant increase in the concentration of malondialdehyde, however, this increase was the steepest for the CCABG group. On arrival at the intensive care unit the mean concentration decreased significantly for all groups. We found only mild organ ischemia/reperfusion injury and oxidative stress in the OPCAB group and the MCABG group with respect to the CCABG group.

Key Words: Off-pump; CABG, Mini-CABG; Oxidative stress; Malondialdehyde; Uric acid