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INTRODUCTION: Heart-type fatty acid-binding protein (H-FABP) is a novel indicator of myocardial damage. The aim of the study was to compare the levels of H-FABP in off-pump and on-pump coronary artery bypass grafting (CABG). MATERIAL AND METHODS: Thirty non-randomised 30 patients who underwent CABG between January 2009 and January 2010 were enrolled in the study. Patients were divided into two equal size (n = 15) groups as group A (off-pump CABG group) and group B (on-pump CABG group). Three arterial blood samples were obtained for H-FABP after sternotomy (H-FABP 1), after the last distal anastomosis in group A and immediately after the cross clamp was removed from the aorta in group B (H-FABP 2) and 24 h after the operation (H-FABP 3). Renal and liver functions and circulating fatty acid binding protein (FABP) levels were also assessed in blood samples obtained 24 h before and 1 h after the operation. RESULTS: At all three assessment points patients in group B had significantly higher H-FABP values when compared with group A. Preoperative renal and liver functions were similar in both groups and they did not differ significantly in group A and group B when preoperative and postoperative values were compared. In both groups circulating FABP levels increased in the postoperative period, and the increase was more pronounced in the on-pump CABG group. CONCLUSIONS: On-pump surgery resulted in higher levels of H-FABP as an ischaemic marker in patients receiving coronary artery bypass surgery.
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INTRODUCTION: Cyanoacrylate ablation is the newest nonthermal vein ablation technique. The one-year results of a prospective comparative study of a new cyanoacrylate glue versus endovenous laser ablation for the treatment of venous insufficiency is presented. MATERIAL AND METHODS: A total of 310 adult subjects were treated with cyanoacrylate ablation or endovenous laser ablation. The primary endpoint of this study was complete occlusion of the great saphenous vein. Secondary endpoints were procedure time, procedural pain, ecchymosis at day 3, adverse events, changes from baseline in Venous Clinical Severity Score, and Aberdeen Varicose Vein Questionnaire. RESULTS: Operative time was shorter (15 ± 2.5 versus 33.2 ± 5.7, <0.001), and periprocedural pain was less (3.1 ± 1.6 versus 6.5 ± 2.3, <0.001) in cyanoacrylate ablation group compared to the endovenous laser ablation group. Ecchymosis at the third day was also significantly less in cyanoacrylate ablation group (<0.001). Temporary or permanent paresthesia developed in seven patients in endovenous laser ablation group and none in cyanoacrylate ablation group (p = 0.015). One, three, and 12 months closure rates were 87.1, 91.7, and 92.2% for endovenous laser ablation and 96.7, 96.6, and 95.8% for cyanoacrylate ablation groups. Closure rate at first month was significantly better in cyanoacrylate ablation group (<0.001). Although there is a trend of better closure rates in cyanoacrylate ablation patients, this difference did not reach to the statistical difference at sixth and 12th month (p = 0.127 and 0.138, respectively). Both groups had significant improvement in Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire postoperatively (<0.001), but there was no significant difference in Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire scores between the groups at first, sixth, and 12 months. Only a slightly better well-being trend was noted in cyanoacrylate ablation group in terms of Aberdeen Varicose Vein Questionnaire scores (p = 0.062). CONCLUSIONS: The efficacy and safety analysis shows that cyanoacrylate ablation is a safe, simple method which can be recommended as an effective endovenous ablation technique. The follow-up data more than one year will clarify the future role of cyanoacrylate ablation for the treatment incompetent great saphenous veins.