Myocardial protection during CABG: Warm blood versus cold crystalloid cardioplegia, is there any difference?

Background: Up till now there is lack of consensus to the optimal method for cardioplegia delivery in coronary artery bypass graft (CABG) patients. Various strategies have been developed to minimize ischemic-reperfusion injury. The aim of this study was to compare cold crystalloid cardioplegia and warm blood cardioplegia in patients undergoing CABG. Methods: Patients (n = 100) undergoing CABG were prospectively randomized into group 1 (n = 50) which received antegrade cold crystalloid cardioplegia, group 2 (n = 50) which received antegrade warm blood cardioplegia. Blood samples were collected immediately, 12, and 24 h postoperatively and CK, CKMB, and Cardiac Troponin I were measured and compared between the two groups which were the indicator of myocardial cell injury (the primary end point of this study). Other indicators such as spontaneous defibrillation, use of intra-aortic balloon counter pulsation (IABC), and use of inotropic support were also documented. Results: Preoperative demographic and clinical variables were matched in both groups. However, intraoperatively, the use of inotropic support was significantly higher in Group I compared to Group II (P = 0.032). Postoperative CK, CKMB and Troponin I were significantly higher in group (I) compared to group (II). Conclusion: A significant reduction in the release of cardiac enzymes in patients who received antegrade warm blood cardioplegia suggests better myocardial protection compared to cold crystalloid cardioplegia

Cohort profile. the ESC-EORP chronic ischemic cardiovascular disease long-term (CICD LT) registry

The European Society of cardiology (ESC) EURObservational Research Programme (EORP) Chronic Ischemic Cardiovascular Disease registry Long Term (CICD) aims to study the clinical profile, treatment modalities and outcomes of patients diagnosed with CICD in a contemporary environment in order to assess whether these patients at high cardiovascular risk are treated according to ESC guidelines on prevention or on stable coronary disease and to determine mid and long term outcomes and their determinants in this population