Dynamics of myocardial necrosis biomarkers and acid-base balance parameters after coronary artery bypass grafting on beating-heart depending on the perioperative glucose-lowering treatment regimen in patients with type II diabetes
The study included 71 patient with ischemic coronary disease (ICD) with type II diabetes mellitus (DM) treated by oral hypoglycemic agents undergoing off-pump coronary artery bypass grafting (CABG). The mean age was 59 (56-64) years. Before the surgery the patients were randomized to continuing of o...
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| Format: | Article |
| Language: | Russian |
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Scientific Сentre for Family Health and Human Reproduction Problems
2015-11-01
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| Series: | Acta Biomedica Scientifica |
| Subjects: | |
| Online Access: | https://www.actabiomedica.ru/jour/article/view/131 |
| _version_ | 1797237390374338560 |
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| author | S. Y. Borodashkina K. V. Protasov V. A. Podkamennyi |
| author_facet | S. Y. Borodashkina K. V. Protasov V. A. Podkamennyi |
| author_sort | S. Y. Borodashkina |
| collection | DOAJ |
| description | The study included 71 patient with ischemic coronary disease (ICD) with type II diabetes mellitus (DM) treated by oral hypoglycemic agents undergoing off-pump coronary artery bypass grafting (CABG). The mean age was 59 (56-64) years. Before the surgery the patients were randomized to continuing of oral hypoglycemic agents (n = 34) or to switching to rapid-acting insulin (n = 37). In the studied groups we compared glycemic parameters, markers of myocardial necrosis (troponin T and creatinine phosphokinase-MB (CPK-MB)) and acid-base balance, as well as their dynamics during the perioperative period. The relationships of myocardial necrosis markers dynamics with glucose metabolism and acid-base balance parameters were investigated. Before the surgery in switched to rapid-acting insulin patients serum glucose, its daily variability and the proportion of blood glucose values less than recommended perioperative range (6,1-10,0 mmol/l) were higher than in those at oral hypoglycemic agents. The myocardial necrosis markers at the day before and 24 h after surgery as well as lactate level and blood acidity during and at 24 hours after surgery were higher in the insulin-group. The insulin-group was characterized by greater increase of troponin T during 24 h after surgery (0,36 [0,25-0,40] vs 0,2 [0,1-0,25] ng/ml; p < 0,001) and CPK-MB (14 [8,0-17,0] vs 7,3 [1,5-8,7] U/L; p < 0,001). Troponin T and CPK-MB dynamics correlated with serum glucose during surgery (r = +0,81 and r = +0,66 respectively), daily serum glucose variability at the day before surgery (r = +0,71 and r = +0,63) and the first day of admission to hospital (r = +0,37 and r = +0,31). |
| first_indexed | 2024-03-08T12:18:42Z |
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| id | doaj.art-20441733a38741feac40fa9d3c6ab5fa |
| institution | Directory Open Access Journal |
| issn | 2541-9420 2587-9596 |
| language | Russian |
| last_indexed | 2024-04-24T17:18:59Z |
| publishDate | 2015-11-01 |
| publisher | Scientific Сentre for Family Health and Human Reproduction Problems |
| record_format | Article |
| series | Acta Biomedica Scientifica |
| spelling | doaj.art-20441733a38741feac40fa9d3c6ab5fa2024-03-28T07:49:15ZrusScientific Сentre for Family Health and Human Reproduction ProblemsActa Biomedica Scientifica2541-94202587-95962015-11-01061116131Dynamics of myocardial necrosis biomarkers and acid-base balance parameters after coronary artery bypass grafting on beating-heart depending on the perioperative glucose-lowering treatment regimen in patients with type II diabetesS. Y. Borodashkina0K. V. Protasov1V. A. Podkamennyi2Irkutsk Regional Clinical HospitalIrkutsk State Medical Academy of Continuing EducationIrkutsk State Medical Academy of Continuing EducationThe study included 71 patient with ischemic coronary disease (ICD) with type II diabetes mellitus (DM) treated by oral hypoglycemic agents undergoing off-pump coronary artery bypass grafting (CABG). The mean age was 59 (56-64) years. Before the surgery the patients were randomized to continuing of oral hypoglycemic agents (n = 34) or to switching to rapid-acting insulin (n = 37). In the studied groups we compared glycemic parameters, markers of myocardial necrosis (troponin T and creatinine phosphokinase-MB (CPK-MB)) and acid-base balance, as well as their dynamics during the perioperative period. The relationships of myocardial necrosis markers dynamics with glucose metabolism and acid-base balance parameters were investigated. Before the surgery in switched to rapid-acting insulin patients serum glucose, its daily variability and the proportion of blood glucose values less than recommended perioperative range (6,1-10,0 mmol/l) were higher than in those at oral hypoglycemic agents. The myocardial necrosis markers at the day before and 24 h after surgery as well as lactate level and blood acidity during and at 24 hours after surgery were higher in the insulin-group. The insulin-group was characterized by greater increase of troponin T during 24 h after surgery (0,36 [0,25-0,40] vs 0,2 [0,1-0,25] ng/ml; p < 0,001) and CPK-MB (14 [8,0-17,0] vs 7,3 [1,5-8,7] U/L; p < 0,001). Troponin T and CPK-MB dynamics correlated with serum glucose during surgery (r = +0,81 and r = +0,66 respectively), daily serum glucose variability at the day before surgery (r = +0,71 and r = +0,63) and the first day of admission to hospital (r = +0,37 and r = +0,31).https://www.actabiomedica.ru/jour/article/view/131coronary artery bypass surgerydiabetes mellitusoral hypoglycemic agentsinsulintroponin tcreatinine phosphokinase-mbacid-base status |
| spellingShingle | S. Y. Borodashkina K. V. Protasov V. A. Podkamennyi Dynamics of myocardial necrosis biomarkers and acid-base balance parameters after coronary artery bypass grafting on beating-heart depending on the perioperative glucose-lowering treatment regimen in patients with type II diabetes Acta Biomedica Scientifica coronary artery bypass surgery diabetes mellitus oral hypoglycemic agents insulin troponin t creatinine phosphokinase-mb acid-base status |
| title | Dynamics of myocardial necrosis biomarkers and acid-base balance parameters after coronary artery bypass grafting on beating-heart depending on the perioperative glucose-lowering treatment regimen in patients with type II diabetes |
| title_full | Dynamics of myocardial necrosis biomarkers and acid-base balance parameters after coronary artery bypass grafting on beating-heart depending on the perioperative glucose-lowering treatment regimen in patients with type II diabetes |
| title_fullStr | Dynamics of myocardial necrosis biomarkers and acid-base balance parameters after coronary artery bypass grafting on beating-heart depending on the perioperative glucose-lowering treatment regimen in patients with type II diabetes |
| title_full_unstemmed | Dynamics of myocardial necrosis biomarkers and acid-base balance parameters after coronary artery bypass grafting on beating-heart depending on the perioperative glucose-lowering treatment regimen in patients with type II diabetes |
| title_short | Dynamics of myocardial necrosis biomarkers and acid-base balance parameters after coronary artery bypass grafting on beating-heart depending on the perioperative glucose-lowering treatment regimen in patients with type II diabetes |
| title_sort | dynamics of myocardial necrosis biomarkers and acid base balance parameters after coronary artery bypass grafting on beating heart depending on the perioperative glucose lowering treatment regimen in patients with type ii diabetes |
| topic | coronary artery bypass surgery diabetes mellitus oral hypoglycemic agents insulin troponin t creatinine phosphokinase-mb acid-base status |
| url | https://www.actabiomedica.ru/jour/article/view/131 |
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