Dataset Information

Association between serum angiotensin-converting enzyme 2 levels and postoperative myocardial infarction following coronary artery bypass grafting.

ABSTRACT: Myocardial infarction (MI) is a predominant and severe complication in patients that undergo aortocoronary bypass surgery. Angiotensin-converting enzyme 2 (ACE2) activation is reportedly a protective mechanism in MI; therefore, in the present study, the association between serum ACE2 levels and postoperative MI following coronary artery bypass grafting (CABG) was investigated. Preoperative and postoperative serum ACE2 levels in 136 subjects undergoing CABG were observed and the serum ACE2 levels, 1 h post surgery, were divided into quartile categories. Following adjustment for age, gender, body mass index, hypertension, previous MI, current smoking status, hyperlipidemia, diabetes mellitus, Gensini score, aortic clamp time, number of grafts and pre-CABG medications; the risk of developing postoperative MI following CABG was observed to be significantly higher in the lowest serum ACE2 level quartile than when compared with the highest quartile (hazard ratio, 2.94; 95% confidence interval, 1.85-4.16; P=0.009). The subjects that exhibited a serum ACE2 level ?1.06 ng/ml showed significantly higher rates of postoperative MI, arrhythmia and reduced cardiac output in addition to increased instances of in-hospital mortality post CABG, compared with those exhibiting a serum ACE2 level >1.06 ng/ml. A significant negative correlation was observed between serum ACE2 and serum cardiac troponin I levels, however, no significant association was identified between the serum ACE2 level quartiles and the ACE2 gene polymorphisms. The present study indicated that a low serum ACE2 level, 1 h post CABG was independently associated with an increased risk of postoperative MI. Thus, the serum ACE2 level may be a potential novel prognostic factor for postoperative MI following CABG.

SUBMITTER: Wang M

PROVIDER: S-EPMC4043627 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association between serum angiotensin-converting enzyme 2 levels and postoperative myocardial infarction following coronary artery bypass grafting.

Wang Min M Zhang Wei W Zhou Yu Y Zhou Xinmin X

Experimental and therapeutic medicine 20140327 6

Myocardial infarction (MI) is a predominant and severe complication in patients that undergo aortocoronary bypass surgery. Angiotensin-converting enzyme 2 (ACE2) activation is reportedly a protective mechanism in MI; therefore, in the present study, the association between serum ACE2 levels and postoperative MI following coronary artery bypass grafting (CABG) was investigated. Preoperative and postoperative serum ACE2 levels in 136 subjects undergoing CABG were observed and the serum ACE2 levels ...[more]

PMID: 24926374

Similar Datasets

Project description:BackgroundProlonged or excessive bleeding after cardiac surgery can lead to a broad spectrum of secondary complications. One of the underlying causes is incomplete wound drainage, with subsequent accumulation of blood and clots in the pericardium. We developed the continuous postoperative pericardial flushing (CPPF) therapy to improve wound drainage and reduce postoperative blood loss and bleeding-related complications after cardiac surgery. This study compared CPPF to standard care in patients after coronary artery bypass grafting (CABG).MethodsThis is a single center, open label, randomized trial that enrolled patients at the Amsterdam UMC, location AMC, Amsterdam, the Netherlands. The study was registered at the 'Netherlands Trial Register', study identifier NTR5200 [1]. Adults undergoing CABG were randomly assigned to receive CPPF therapy or standard care, participants and investigators were not masked to group assignment. The primary end point was postoperative blood loss in the first 12-hours after surgery.FindingsBetween the January 15, 2014 and the March 13, 2017, 169 patients were enrolled and assigned to CPPF therapy (study group; n = 83) or standard care (control group; n = 86). CPPF reduced postoperative blood loss when compared to standard care (median differences -385 ml, reduction 76% p=≤0.001), with the remark that these results are overestimated due to a measurement error in part of the study group. None of patients in the study group required reoperation for non-surgical bleeding versus 3 (4%, 95% CI -0.4% to 7.0%) in the control group. None of the patients in the study group suffered from cardiac tamponade, versus 3 (4%, 95% CI -0,4% to 7.0%) in the control group. The incremental cost-effectiveness ratio was €116.513 (95% bootstrap CI €-882.068 to €+897.278).InterpretationThe use of CPPF therapy after CABG seems to reduce bleeding and bleeding related complications. With comparable costs and no improvement in Qualty of Life (QoL), cost consideration for the implementation of CPPF is not relevant. None of the patients in the study group required re-interventions for non-surgical bleeding or acute cardiac tamponade, which underlines the proof of concept of this novel therapy.FundingThis study was funded by ZonMw, the Netherlands organization for health research and development (project 837001405).

Dataset Information

Association between serum angiotensin-converting enzyme 2 levels and postoperative myocardial infarction following coronary artery bypass grafting.

Publications

Association between serum angiotensin-converting enzyme 2 levels and postoperative myocardial infarction following coronary artery bypass grafting.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets