Paradoxical response of plasma lipoprotein(a) in patients undergoing cardiopulmonary bypass
| Autor: | Omar M. Lattouf, Donald C. Finlayson, Demetrios S. Sgoutas, Richard V. Clark |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Adult
Male medicine.medical_specialty Resuscitation Time Factors law.invention chemistry.chemical_compound Coronary artery bypass surgery law Cardiopulmonary bypass Humans Medicine Serum Albumin Triglycerides Aged Cardiopulmonary Bypass biology business.industry Cholesterol Extracorporeal circulation Lipoprotein(a) Middle Aged Cardiac surgery Apolipoproteins C-Reactive Protein chemistry Anesthesia biology.protein lipids (amino acids peptides and proteins) Cardiology and Cardiovascular Medicine business Lipoprotein |
| Zdroj: | Atherosclerosis. 97:29-36 |
| ISSN: | 0021-9150 |
| DOI: | 10.1016/0021-9150(92)90048-l |
| Popis: | Plasma lipid, lipoprotein and apolipoprotein levels are known to decrease after major surgery. Coronary artery bypass surgery additionally involves use of extracorporeal circulation by use of a cardiopulmonary bypass pump, which necessitates hemodilution due to saline dextrose infusion to prime the pump. To investigate changes in lipids, lipoproteins and apolipoproteins as well as changes in C-reactive protein and albumin we conducted a study on 22 patients undergoing cardiac surgery involving cardiopulmonary bypass. Timed arterial blood samples were taken before, during and after cardiopulmonary bypass. At the onset and during cardiopulmonary bypass a rapid and significant fall was observed in all lipids and lipoproteins except lipoprotein(a) with recovery to near basal levels by 72 h for cholesterol, triglycerides, high density lipoprotein cholesterol and albumin, while apolipoproteins AI and B remained below basal levels during the postoperative period up to 72 h. In contrast, lipoprotein(a) levels increased at the onset, doubled during cardiopulmonary bypass and remained elevated postoperatively. On the other hand, C-reactive protein levels fell at the onset and during cardiopulmonary bypass but they became markedly elevated postoperatively. When results were corrected for hemodilution, the response patterns remained unchanged. As lipoprotein(a) is both atherogenic and thrombogenic, its elevation during cardiopulmonary bypass may be clinically important. |
| Databáze: | OpenAIRE |
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