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Heart Enzymes May Predict Outcome After Bypass Surgery
Date:2/8/2011

By Steven Reinberg
HealthDay Reporter

TUESDAY, Feb. 8 (HealthDay News) -- High levels of certain blood enzymes following coronary-artery bypass surgery can signal an increased risk of death, a new study suggests.

For those with the highest enzyme levels, the risk of dying within 30 days was double that of those with the lowest levels.

Elevated levels of creatine kinase or troponin are common after bypass surgery, and small increases were not considered significant until now, the researchers noted.

"When people have a bypass operation done sometimes there is some damage to the heart muscle, and chemicals are released that mark that," said study author Dr. Michael J. Domanski, from the Mount Sinai Cardiovascular Institute in New York City.

"What our study shows is that there is a strong graded association of enzyme elevation with mortality," he said. "More is worse, but even small amounts have an impact on mortality."

Domanski doesn't think that measuring these enzymes after surgery would have any impact on treatment. However, he said that since most of the heart damage occurs during surgery, these enzymes could be measures of the quality of heart operations in different hospitals.

"I'd rather have my bypass operation with somebody who has less enzyme elevation," he said. "The larger their enzyme elevations, the less I'd like to go to them."

The report is published in the Feb. 9 issue of the Journal of the American Medical Association.

Domanski and his colleagues set out to study the effect of elevated enzymes on short- and long-term patient outcome after coronary-artery bypass surgery to replace blocked heart arteries. To do this, they conducted a meta-analysis, which consists of reviewing published studies to look for patterns.

They identified seven studies that included 18,908 patients who underwent CABG and were followed for three months to five years.

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