Relationship between epoxyeicosatrienoic acid, N-terminal brain natriuretic peptide precursor and troponin in early complications after coronary artery bypass grafting

Objective To investigate the relationship between epoxyeicosatrienoic acid (EET), N-terminal brain natriuretic peptide precursor (NT-proBNP) and troponin (cTnI) in the early complications after coronary artery bypass grafting (CABG).

Methods Patients undergoing CABG under general anesthesia with extracorporeal circulation were selected as study subjects and divided into complication group (n=39) and non-complication group (n=66) according to the presence or absence of postoperative complications, and patients' preoperative EET, basal data, intraoperative extracorporeal circulation time, ascending aortic block time, number of graft vessels, and NT-proBNP and cTnI levels at 24, 48, and 72 h after operation were recorded.

Results The age and body mass index of patients in the complication group were higher than those in the non-complication group (P < 0.05).The left ventricular ejection fraction, 14, 15-EET levels in the complication group were lower than those in the non-complication group (P < 0.05).The extracorporeal circulation time, blocking time, and postoperative ICU stay time in the complication group were higher than those in the non-complication group (P < 0.05).The levels of serum NT-proBNP and cTnI in the two groups showed statistical significance at different time points (P < 0.01).The serum NT proBNP and cTnI levels in the complication group were higher than those in the non-complication group at 24, 48, and 72 h after surgery (P < 0.01).14, 15-EET was a risk factor for postoperative complications of CABG under cardiopulmonary bypass (P < 0.01).The AUC for predicting early postoperative complications using 14, 15-EET was 0.772 (95%CI: 0.682-0.863), with a critical value of 49.05 μg/L, sensitivity of 78.8%, and specificity of 64.1%.The 24-hour cTnI level showed a significant negative correlation with the levels of 14, 15-EET (r=-0.253, P < 0.05).

Conclusions Low preoperative serum EET levels in CABG patients are associated with the occurrence of complications, and preoperative serum EET levels have predictive value for early postoperative complications, and NT-proBNP and cTnI at different postoperative times can provide an early assessment of patient prognosis.