Author/Editor		Blumauer, Robert
Title		Povezava med plazemskim proteinom A, povezanim z nosečnostjo, in encimi srčno mišičnega razpada pri bolnikih, operiranih na srcu
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2002
Volume		str. 49
Language		slo
Abstract		Background Metaloproteinase, pregnancy-associated plasma protein A (PAPP A), is a new can didate marker for early diagnosis of an acute coronary syndrome in the patients with coronary artery disease. A threshold level of 10 mU of PAPP-A per liter had the highest combined sensitivity and specificity for the identification of acute coronary syndromes. In conventional cardiac surgery, the rate of perioperative ishemia and myocardial infarct are reported in the 2 to 8% range, and as complications elevate mortality and morbidity in patients who underwent coronary artery bypass grafting or valve surgery. In our study we investigated the potential of PAPP A as good serum marker to identify patients with perioperative coronary syndrome as we suggest naming the acute coronary syndrome after a heart surgery. Systemic and nonspecific body reaction as a result of a blood contact with artificial materials during extra-corporal circulation (ECC), hypothermia and cardiac arrest activate numerous humoral and cell defensive responses. We suppose that IGF I and PAPP A also participate in these reactions, which could be the main reason for their blood level elevation after an operation with ECC. Methods We studied 65 consecutive patients who underwent heart operation at the Department for Cardiovascular surgery at the University Medical Center in Ljubljana. According to the technique and kind of operation, the patients were divided into five groups (first: coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) in cardiac arest (n=19), second: CABG without CPB (n=16), the third group of patients underwent valve operation with CPB and in cardiac arest (n=17), the fourth group of patients underwent valve operation with CPB and without cardiac arest (n=5) and the fifth group: patients who were operated valves and coronary artery at the same time (n=8)). (Abstract truncated at 2000 characters).
Descriptors		CORONARY ARTERY BYPASS CARDIOPULMONARY BYPASS HEART VALVE DISEASES POSTOPERATIVE COMPLICATIONS PREGNANCY-ASSOCIATED ALPHA-PLASMA PROTEIN CORONARY DISEASE MYOCARDIAL INFARCTION ANGINA, UNSTABLE HEART ARREST RETROSPECTIVE STUDIES CREATINE KINASE HEMATOCRIT C-REACTIVE PROTEIN ASPARTATE AMINOTRANSFERASE ALANINE AMINOTRANSFERASE TROPONIN LIPOPROTEINS, LDL GAMMA-GLUTAMYLTRANSFERASE INSULIN-LIKE GROWTH FACTOR I