Role of induced blood oxidation parameters in the pathogenesis of complications during myocardial revascularization

Background. Despite its proven positive impact on prognosis and quality of life, coronary artery disease (CAD) surgical treatment is accompanied by the development of ischemia-reperfusion injury, a phenomenon underpinned by oxidative stress that mediates the development of the most common postoperative complications.
Materials and methods. The study group consisted of 89 patients with CAD, including 64 patients who underwent coronary artery bypass grafting. The control group consisted of 24 healthy volunteers. Blood oxidation parameters were assessed using a YSI 5300 biological oxygen monitor (Yellow Springs Instrument Co., Inc., USA).
Results. In patients with CAD, compared with the control group, higher values of Vox (2.07 > 1.9; p = 0.049), Vinit (3.29 > 2.11; p = 0.0001), Vmax (3.5 > 2.54; p = 0.001), coefficient of oxidative activity (KA) (40.0 > 5.89, p = 0.0001), and a shorter initiation period (T) (0.97 < 1.91; p = 0.001) were observed. In the comparative aspect, statistically significant differences in the indices of induced blood oxidation depending on the type of cardiac surgery were not observed either 10 days (B2) or 6 months after the operation (B3). In the group of patients who had previously suffered a myocardial infarction, the Vox values were statistically significantly higher in the event of a fatal outcome (2.3 (2.3; 2.5) and 1.9 (1.7; 2.3), respectively (p = 0.04). The results of the logistic regression analysis demonstrated a statistically significant effect of the Vox value on the development of cardiac arrhythmias (p = 0.0001) and cognitive dysfunction (p = 0.004) in the postoperative period.
Conclusions. Patients with CAD had higher blood oxidation parameters. The choice of revascularization technique (cardiopulmonary bypass or off-pump surgery) did not affect these parameters. However, monitoring these parameters during perioperative patient care appears to be useful for predicting the development of complications such as cardiac arrhythmias and postoperative cognitive dysfunction.

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