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Quantification of Myocardial Injury During Coronary Artery Bypass Graft

Serial intraoperative myocardial-specific creatine-kinase (MB-CK) samples were obtained in 32 patients undergoing coronary artery bypass graft (CABG). Based upon their postoperative ECG and technetium pyrophosphate SCAN results, each patient was classified as either Group A (MI), B (normal), or C (equivocal). Peak MB-CK was reported for each group. The mean value for Group A (75 ± 17 IU/L) is higher than for Group B (18 ± 1 IU/L) or Group C (30 ± I U /L). The concept of measuring and a formula for calculation of intraoperative myocardial injury are presented. The mean value for Group A (MI, 10,709 ± 5885) is higher than either groups B (normal) or C (equivocal) by a test of proportionality (P < 0.001). Likewise, Group C (898 ± 159) is higher than B (466 ± 71) (P < 0.05). This index, while in need of further validation, corresponds closely to the clinical status of the 32 patients studied and should provide a means more refined than mortality or incidence of MI upon which to judge efficacy of any proposed means of operative myocardial preservation.