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- Title
Use of del Nido cardioplegia in acute coronary syndrome cases with decreased ejection fraction.
- Authors
Sanetra, Krzysztof; Gerber, Witold; Domaradzki, Wojciech; Mazur, Marta; Synak, Magdalena; Kubaszewska, Marta; Kaźmierczak, Paweł; Buszman, Piotr P; Bochenek, Andrzej
- Abstract
Background: There has been increasing interest in using del Nido cardioplegia in adult cardiac surgery. However, there is limited evidence for its efficacy in patients with acute coronary syndrome and reduced ejection fraction. Methods: This study examined patients with decreased ejection fraction (EF < 40%) who were hospitalized due to acute coronary syndrome and received either del Nido (DN) or cold blood cardioplegia (CB). The patients were matched based on age, gender, myocardial infarction at baseline, and number of conducted surgical procedures. An analysis was conducted on postoperative biomarker release (high-sensitivity troponin T and isoenzyme creatine kinase-MB (CK-MB)), changes in myocardial contractility and perioperative outcomes. Results: 62 pairs of patients with similar baseline characteristics were selected. 51.6% of pairs underwent isolated coronary artery bypass grafting, while 48.4% underwent a complex procedure. Postoperative troponin values did not differ significantly at 12 h (median (IQR): 606.7 (381.4–974.8) pg/mL vs. 552 (231.8–1579.5) pg/mL; p = 0.913), nor did CK-MB (median (IQR): 24.3 (12.6–45.5) ng/mL vs. 23.7 (12.3–49.8) ng/mL; p = 0.972). The postoperative EF was similar between groups (median (IQR): 30% (30–35%) vs. 34% (30–38%); p = 0.323). No difference in perioperative mortality, myocardial infarction, stroke, or composite endpoint was noted. In a multivariate analysis, the cardioplegia protocol did not affect biomarker release or changes in ejection fraction. The first stage of acute kidney injury was more frequent in the CB group (28.5% vs. 9.7%, p = 0.033). Conclusions: Both del Nido and cold blood cardioplegia provide adequate cardioprotection in patients with acute coronary syndrome with decreased ejection fraction.
- Subjects
DRUG efficacy; CAUSES of death; VENTRICULAR ejection fraction; CARDIOPLEGIC solutions; ACUTE coronary syndrome; RETROSPECTIVE studies; PERFUSIONISTS; CREATINE kinase; MAGNETIC resonance imaging; MANN Whitney U Test; COMPARATIVE studies; DESCRIPTIVE statistics; HOSPITAL care; CHI-squared test; COMPUTED tomography; LOGISTIC regression analysis; HEART failure
- Publication
Perfusion, 2024, Vol 39, Issue 2, p353
- ISSN
0267-6591
- Publication type
Article
- DOI
10.1177/02676591221144166