Early diagnosis of perioperative XXXX after coronary bypass grafting: a study using biomarkers and cardiac magnetic resonance imaging.

@entity1 @entity650 @entity296 @entity3335 @entity39 @entity5 @entity908 @entity6949 @entity2842 @entity583 @entity2287 @entity1851
BACKGROUND: @entity296 related to coronary artery bypass grafting (CABG) is poorly characterized, and understanding the characteristic release of biomarkers associated with revascularization injury might provide novel therapeutic opportunities. This study characterized early changes in biomarkers after revascularization injury during on-pump CABG. METHODS: This prospective study comprised 28 @entity1 undergoing on-pump CABG and late @entity2287 enhancement (LGE) cardiac magnetic resonance imaging (CMRI) who underwent measurements of @entity6949 ( @entity6949 ), @entity908 kinase-MB, and inflammatory markers ( @entity1851 , serum amyloid A, @entity3335 , @entity650 , @entity5 @entity39 factor-a, @entity2842 , plasminogen activator inhibitor-1a) at baseline, at 1, 6, 12, and 24 hours, and at 1 week (inflammatory markers only) post-CABG. Biomarker results at 1 hour were studied for a relationship to new @entity583 as defined by CMRI-LGE, and the diagnostic utility of combining positive biomarkers was assessed. RESULTS: All @entity1 had an uneventful recovery, but 9 showed a new @entity583 demonstrated by new areas of hyperenhancement on CMR. Peak @entity6949 at 24 hours (   = 0.66, p < 0.001) and CK-MB (   = 0.66, p < 0.001) correlated with the amount of new LGE. At 1 hour, 3 biomarkers-- @entity6949 , @entity650 , and @entity5 @entity39 factor-a--were significantly elevated in @entity1 with vs those without new LGE. Receiver operating curve analysis showed @entity6949 was the most accurate at detecting new LGE at 1 hour: a cutoff of @entity6949 exceeding 5  g/L at 1 hour had 67% sensitivity and 79% specificity for detecting new LGE. CONCLUSIONS: Unexpected CABG-related @entity296 occurs in a significant proportion of @entity1 . A @entity6949 test at 1 hour after CABG could potentially differentiate @entity1 with significant revascularization injury.
