Document Detail

Detection of perioperative myocardial damage after coronary artery bypass graft surgery.
MedLine Citation:
PMID:  186217     Owner:  NLM     Status:  MEDLINE    
In order to evaluate methods for detecting peri-operative myocardial damage we studied 41 patients before and serially following coronary artery bypass graft surgery utilizing the 12-lead ECG, serum MB-CPK measurements, and 99mTc pyrophosphate myocardial scans. Six of the 41 patients (15%) developed persistent new Q waves after surgery. Six other patients demonstrated ischemic ST-T wave changes that persisted for 48 hours or more. Mean total MB-CPK released was highest for the group with new Q waves [1598+/-545 (SE) I.U./L-hr] as compared to the group with ischemic ST-T wave changes 708+/-65 I.U./L-hr) or the group with no ECG changes (262+/-47 I.U./L-hr). Ten patients (24%) has positive postoperative pyrophosphate scans consistent with myocardial infarction. The three techniques were compared in these 41 patients utilizing 465 I.U./L.-hr as the upper limit of normal MB-CPK released after uncomplicated coronary bypass surgery (no ECG changes, negative scan). Five patients with ischemic ECG changes had a positive scan and high MB-CPK; six patients with no ECG changes had high MB-CPK but a negative scan; and one patient with high MB-CPK and new Q wave had a negative scan. We conclude 1) new Q waves on ECG underestimate the incidence of myocardial damage after coronary artery surgery; 2) MB-CPK alone overestimates the incidence of infarction; and 3) a combination of the three techniques is the best means for detecting myocardial damage after coronary artery bypass graft surgery.
A Righetti; M H Crawford; R A O'Rourke; T Hardarson; H Schelbert; P O Daily; M DeLuca; W Ashburn; J Ross
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  55     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1977 Jan 
Date Detail:
Created Date:  1977-01-29     Completed Date:  1977-01-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  173-8     Citation Subset:  AIM; IM    
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MeSH Terms
Coronary Artery Bypass / adverse effects*
Creatine Kinase / diagnostic use
Diphosphates / diagnostic use
Heart Diseases / diagnosis,  etiology*
Isoenzymes / diagnostic use
Middle Aged
Myocardial Infarction / diagnosis,  etiology
Myocardium / enzymology
Reg. No./Substance:
0/Diphosphates; 0/Isoenzymes; EC Kinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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