Ischemia-Modified Albumin Reduction after Coronary Bypass Surgery Is Associated with the Cardioprotective Efficacy of Cold-Blood Cardioplegia Enriched with N-Acetylcysteine: A Preliminary Study

KARAHAN S. C., Koramaz I., Altun G., Ucar U., TOPBAŞ M., MENTEŞE A., ...More

EUROPEAN SURGICAL RESEARCH, vol.44, no.1, pp.30-36, 2010 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 44 Issue: 1
  • Publication Date: 2010
  • Doi Number: 10.1159/000262324
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.30-36
  • Keywords: Ischemia-modified albumin, N-acetylcysteine, Coronary artery bypass grafting, MYOCARDIAL-ISCHEMIA, OXIDATIVE STRESS, CARDIAC-SURGERY, REACTIVE OXYGEN, COBALT BINDING, MARKER, INCREASES, DIAGNOSIS, INJURY
  • Karadeniz Technical University Affiliated: Yes


Background: The aims of this preliminary study were to determine the alteration of serum ischemia-modified albumin (IMA) levels and to investigate whether IMA may be used as an indicator of the cardioprotective efficacy of N-acetylcysteine (NAC) in patients undergoing coronary bypass grafting (CABG). Patients and Methods: Forty-four patients were randomized into one of two groups on the basis of cardioplegic strategies, either cold-blood cardioplegia enriched with NAC (50 mg/kg) or cold-blood cardioplegia alone. Serum IMA, cardiac troponin T (cTnT) and malondialdehyde (MDA) levels determined in NAC-enriched patients before and after CABG were compared with those of the NAC-free group. The albumin cobalt binding assay was used for IMA determination. Results: Serum IMA levels were significantly elevated after cross-clamping and peaked at 6 h after reperfusion in the two groups. In NAC-enriched patients, IMA levels determined 6, 12, 24 and 48 h after reperfusion were significantly lower than those of the NAC-free group (p <= 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). IMA returned to baseline 24 h after reperfusion differently from cTnT and MDA in the NAC-enriched group. Conclusions: IMA may be used as not only an indicator of myocardial ischemia-reperfusion injury, but also as a useful indicator of the cardioprotective effect of NAC in CABG. Copyright (C) 2009 S. Karger AG, Basel