Cardioprotective Effect of Low Level of LDL Cholesterol on Perioperative Myocardial Injury in Off-Pump Coronary Artery Bypass Grafting
<i>Background and Objectives</i>: Coronary artery disease is still a major cause of death in developed countries. Low-density lipoprotein cholesterol (LDL-C) lowering with statin therapy is a key strategy in major acute coronary events’ prevention. The aim of the study was to establish i...
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MDPI AG
2021-08-01
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| Online Access: | https://www.mdpi.com/1648-9144/57/9/875 |
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| author | Tomasz Kamil Urbanowicz Anna Olasińska-Wiśniewska Michał Michalak Aleksandra Gąsecka Michał Rodzki Bartłomiej Perek Marek Jemielity |
| author_facet | Tomasz Kamil Urbanowicz Anna Olasińska-Wiśniewska Michał Michalak Aleksandra Gąsecka Michał Rodzki Bartłomiej Perek Marek Jemielity |
| author_sort | Tomasz Kamil Urbanowicz |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Coronary artery disease is still a major cause of death in developed countries. Low-density lipoprotein cholesterol (LDL-C) lowering with statin therapy is a key strategy in major acute coronary events’ prevention. The aim of the study was to establish if there is a cardioprotective effect of pre-operative LDL lowering therapy on perioperative myocaridal injury in patients undergoing off-pump coronary artery bypass grafting (CABG). Moreover, the impact of pre-operative LDL level on long term outcome was analysed. <i>Materials and Methods</i>: The retrospective single center analysis included 662 consecutive patients (431 (65%) males and 231 (35%) female, mean age of 65 ± 8) referred for cardiac surgery due to stable chronic coronary syndrome between 2012–2018. The follow up was 9 years. <i>Results</i>: A statistically significant difference was found in postoperative serum Troponin-I for LDL thresholds of 1.8 mmol/L (<i>p</i> = 0.009), 2.6 mmol/L (<i>p</i> = 0.03) and 3.0 mmol/L (<i>p</i> = 0.001). The results indicate that cardioprotective role of LDL is achieved within LDL concentration rate below 1.8 mmol/L (<70 mg/dL). Five patients died perioperatively, whereas 1-year and 9-year overall mortality rates were 4% (<i>n</i> = 28) and 18.6% (<i>n</i> = 123), respectively. Comparing the survival group with diseased, Mann-Whitney U test showed a statistically significant difference in HDL-C (<i>p</i> = 0.007), Troponin (<i>p</i> = 0.009), Castelli index (<i>p</i> = 0.001) and atherogenic index (<i>p</i> = 0.004). Preoperative levels of total cholesterol, LDL-C and HDL-C did not significantly differ between survivors and diseased. The 9-year mortality risk did not differ significantly between subgroups divided according to LDL-C thresholds of 1.4 mmol/L (55 mg/dL), 1.8 mmol/L (70 mg/dL), 2.6 mmol/L (100 mg/dL) and 3.0 mmol/L (116 mg/dL). <i>Conclusions:</i> Preoperative low level of LDL-C cholesterol (below 1.83 mmol/L, 70 mg/dL) has a cardioprotective effect on perioperative myocardial injury in off-pump coronary artery bypass grafting. |
| first_indexed | 2024-03-10T07:28:08Z |
| format | Article |
| id | doaj.art-88cca5a25981401ebd2a577365f00c09 |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T07:28:08Z |
| publishDate | 2021-08-01 |
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| series | Medicina |
| spelling | doaj.art-88cca5a25981401ebd2a577365f00c092023-11-22T14:07:35ZengMDPI AGMedicina1010-660X1648-91442021-08-0157987510.3390/medicina57090875Cardioprotective Effect of Low Level of LDL Cholesterol on Perioperative Myocardial Injury in Off-Pump Coronary Artery Bypass GraftingTomasz Kamil Urbanowicz0Anna Olasińska-Wiśniewska1Michał Michalak2Aleksandra Gąsecka3Michał Rodzki4Bartłomiej Perek5Marek Jemielity6Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznań, PolandCardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznań, PolandDepartment of Computer Science and Statistics, Poznan University of Medical Sciences, 60-529 Poznań, Poland1st Chair and Department of Cardiology, Medical University of Warsaw, 02-106 Warsaw, PolandCardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznań, PolandCardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznań, PolandCardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznań, Poland<i>Background and Objectives</i>: Coronary artery disease is still a major cause of death in developed countries. Low-density lipoprotein cholesterol (LDL-C) lowering with statin therapy is a key strategy in major acute coronary events’ prevention. The aim of the study was to establish if there is a cardioprotective effect of pre-operative LDL lowering therapy on perioperative myocaridal injury in patients undergoing off-pump coronary artery bypass grafting (CABG). Moreover, the impact of pre-operative LDL level on long term outcome was analysed. <i>Materials and Methods</i>: The retrospective single center analysis included 662 consecutive patients (431 (65%) males and 231 (35%) female, mean age of 65 ± 8) referred for cardiac surgery due to stable chronic coronary syndrome between 2012–2018. The follow up was 9 years. <i>Results</i>: A statistically significant difference was found in postoperative serum Troponin-I for LDL thresholds of 1.8 mmol/L (<i>p</i> = 0.009), 2.6 mmol/L (<i>p</i> = 0.03) and 3.0 mmol/L (<i>p</i> = 0.001). The results indicate that cardioprotective role of LDL is achieved within LDL concentration rate below 1.8 mmol/L (<70 mg/dL). Five patients died perioperatively, whereas 1-year and 9-year overall mortality rates were 4% (<i>n</i> = 28) and 18.6% (<i>n</i> = 123), respectively. Comparing the survival group with diseased, Mann-Whitney U test showed a statistically significant difference in HDL-C (<i>p</i> = 0.007), Troponin (<i>p</i> = 0.009), Castelli index (<i>p</i> = 0.001) and atherogenic index (<i>p</i> = 0.004). Preoperative levels of total cholesterol, LDL-C and HDL-C did not significantly differ between survivors and diseased. The 9-year mortality risk did not differ significantly between subgroups divided according to LDL-C thresholds of 1.4 mmol/L (55 mg/dL), 1.8 mmol/L (70 mg/dL), 2.6 mmol/L (100 mg/dL) and 3.0 mmol/L (116 mg/dL). <i>Conclusions:</i> Preoperative low level of LDL-C cholesterol (below 1.83 mmol/L, 70 mg/dL) has a cardioprotective effect on perioperative myocardial injury in off-pump coronary artery bypass grafting.https://www.mdpi.com/1648-9144/57/9/875cardiac surgerycardiovascular diseaseprognosistherapydrugs |
| spellingShingle | Tomasz Kamil Urbanowicz Anna Olasińska-Wiśniewska Michał Michalak Aleksandra Gąsecka Michał Rodzki Bartłomiej Perek Marek Jemielity Cardioprotective Effect of Low Level of LDL Cholesterol on Perioperative Myocardial Injury in Off-Pump Coronary Artery Bypass Grafting Medicina cardiac surgery cardiovascular disease prognosis therapy drugs |
| title | Cardioprotective Effect of Low Level of LDL Cholesterol on Perioperative Myocardial Injury in Off-Pump Coronary Artery Bypass Grafting |
| title_full | Cardioprotective Effect of Low Level of LDL Cholesterol on Perioperative Myocardial Injury in Off-Pump Coronary Artery Bypass Grafting |
| title_fullStr | Cardioprotective Effect of Low Level of LDL Cholesterol on Perioperative Myocardial Injury in Off-Pump Coronary Artery Bypass Grafting |
| title_full_unstemmed | Cardioprotective Effect of Low Level of LDL Cholesterol on Perioperative Myocardial Injury in Off-Pump Coronary Artery Bypass Grafting |
| title_short | Cardioprotective Effect of Low Level of LDL Cholesterol on Perioperative Myocardial Injury in Off-Pump Coronary Artery Bypass Grafting |
| title_sort | cardioprotective effect of low level of ldl cholesterol on perioperative myocardial injury in off pump coronary artery bypass grafting |
| topic | cardiac surgery cardiovascular disease prognosis therapy drugs |
| url | https://www.mdpi.com/1648-9144/57/9/875 |
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