Monocyte chemotactic protein-1 and E-selectin inflammatory patterns in coronary artery bypass graft surgery with the miniaturized extracorporeal circulation: a randomized clinical trial

摘要

Inflammation and hemodilution are the main drawbacks of extracorporeal circulation. In our study, sixty-one patients undergoing isolated coronary artery bypass graft were prospectively randomized to a miniaturized extracorporeal circulation (n=19), a standard extracorporeal circulation (n=20) or an off-pump surgery (n=22). Blood samples were collected to analyze markers for inflammation and endothelial activation. No differences were observed in early clinical outcome. IL-6 levels increased in every group while TNF-a values increased only in the SECC group (p=0.05). E-selectin systemic values decreased (p=0.001) in every group. MCP-1 systemic and cardiac levels raised only in the SECC group (p=0.014). MECC is comparable with SECC and OPCABG in the clinical outcome of low-risk patients and it is as effective as the OPCABG in the matter of inflammation and endothelial activation.