Poster Presentations / International Journal of Cardiology 163S1 (2013) S81–S211 S187

PP-265

EFFECT OF PREOPERATIVE ANEMIA ON SHORT TERM

OUTCOMES IN DIABETIC PATIENTS AFTER CARDIAC SURGERY

S.J. Mirhosseini, S.A.H. Sayegh. Department of Cardiovascular

Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Background: Diabetic mellitus (DM) is a major risk factor of

morbidity, mortality and economic cost to society. Diabetic patients

are at risk of having microvascular or macrovascular disorders

of diabetes. postoperative anemia have wide spectrum of some

early complications that require more care in hospitalization stays

Therefore, this study was designed to evaluate effect of preoperative

anemia on short-term outcomes in diabetic patients undergoing

elective off-pump CABG.

Methods and Materials: This study conducted on 86 diabetic

patients undergoing elective off pump CABG surgery from August

to October 2011, in Afshar cardiovascular center, Yazd, Iran. The

patients had hemoglobin concentration between 10–12, patients

with preoperative atrial fibrillation and renal and respiratory

dysfunction were excluded from this study. Participants were

randomly assigned into two groups; the normal group (n =42) that

had hemoglobin concentration ~12–15g/dl and the anemic group

(n =44) had hemoglobin concentration ~7–10g/dl. We evaluated

Post-CABG variables including incidence of atrial fibrillation and

early morbidity such as infection, vomiting, renal and respiratory

dysfunctions, ICU or hospital stay and early mortality. Data

were analyzed by ANOVA, Chi-square and Fisher exact test for

quantitative and qualitative variables.

Results: The mean age of the patients was 52.51±6.9 years, from

all of patients 64 cases (74.4%) were male and 22 cases (445.6%)

were female. Postoperative atrial fibrillation observed in 17 cases

(19.8%), 7 cases (16.7%) of whom were in normal group and 10 cases

(22.7%) of whom were in anemia group. Anemia could significantly

increase hospital stay (p = 0.0001) but no ICU stay.

Conclusion: Preoperative anemia did not affect the incidence of

AF and early complications and mortality in patients undergoing

off-pump CABG. However, anemia could increase postoperative

hospital stay and renal dysfunction significantly.

PP-266

INTRA-OPERATIVE GRADING OF CORONARY ARTERY

ATHEROSCLEROSIS IS ASSOCIATED WITH HOMOCYSTEINE

LEVEL IN MENOPAUSAL WOMEN WHO ARE CANDIDATES FOR

OFF-PUMP CABG SURGERY

S.J. Mirhosseini, S.K. Forouzannia, S.A. Mirhosseini, S.A.H. Sayegh.

Department of Cardiovascular Surgery, Shahid Sadoughi University of

Medical Sciences, Yazd, Iran

Background: whereas the death rate from coronary artery disease

(CAD) is five to eight times greater in men than in women during

ages 25–55 years, this difference in mortality rate slows down

considerably after menopause suggesting that pre menopausal

women have vascular and endothelial protective factors lost after

menopause. This protection is attributed to the effects of the female

sex hormone (estrogen). Homocysteine, a sulfur-containing amino

acid product of methionine metabolism, may play an important

role in the development of cardiovascular disease. Homocysteine

significantly increases after menopause. Although several previous

studies have shown an association of hyperhomocysteinemia

with cardiovascular disease, prospective studies have given

conflicting results. Thus, the role of hyperhomocysteinemia in the

development of coronary heart disease is still controversy.

Materials and Methods: 136 postmenopausal women (with the

mean age of 54.9±4 years) who where candidate for elective

off-pump CABG enrolled in this cross sectional study. In every

patient the extent and severity of atherosclerosis was assessed

using intra operative grading (IOG) and Gensini’s score system.

Total homocysteine was determined after 12h fasting with ELISA

method in all patients. The patients were classified in two groups

(diffuse vs. discrete) based on intra-operative findings. Finally the

relation between age, IOG and Ginsini’s score with homocystein

level was assessed with statistical analysis.

Results: There was a direct correlation between intra-operative

grading and homocysteine level in both groups (p = 0.005).

The association between Gensini’s score and homocysteine was

significant in higher levels of hyperhomocysteinamia (>30mmol/L)

(p < 0.05). The homocysteine level also increased with aging,

therefore patients were classified in two categories (<54 years

and ≥54 years) using Levene’s Test. Statistical analysis indicated no

association between IOG, Gensini’s score and homocysteine level

in the patients who were under 54 years of age, but significant

relation was detected between these parameters in the other group

in patients with diffuse or discrete lesions in coronary arteries

(p = 0.001 for both IOG and Gensini’s score).

Conclusion: According to our findings, homocysteine level

increases during post menopause, in other words, post menopausal

women are at risk of hyperhomocysteinemia.

PP-267

SEX HORMONES LEVEL AND SEXUAL DYSFUNCTION IN MEN

AFTER CARDIAC SURGERY

S.K. Forouzannia, M.H. Abdollahi, M.H. Hekmatimoghaddam,

S.A.H. Sayegh. Department of Cardiovascular Surgery, Shahid

Sadoughi University of Medical Sciences, Yazd, Iran

Background: sexual dysfunction is one of the most common

complication in men after Coronary Artery Bypass Graft (CABG).

Etiology of sexual dysfunction in these patients is psychologic or

organic due to hormones changes.

Objective: In this study we evaluate the incidence and type of

sexual dysfunction and changes of sex hormones in male patients

undergoing On-Pump CABG.

Material and Methods: In this before after study we enrolled Forty

men with age under 70 years old candidate for On-pump coronary

artery bypass graft (CABG). Interview before and 12 weeks after

operation in regard to the impact of surgery on their sex hormones

changes and sexual dysfunctions was done. The statistical methods

used for data analysis includes analysis of variance, McNemar and

chi-square analysis.

Result: The man age of the patients was 51.27±7.86 years. Incidence

of sexual dysfunction was 22.5% (9 cases) before and 47.7% (19

cases) after operation. Type of sexual dysfunction before and after

operation include premature ejaculation (before 5%, after 2.5%),

Impotency (before 7.5%, after 12.5) and loss of libido (before 10%,

after 32%). Level of sexual hormones decrease after operation but

it was statistically significant only for estrogen (p value ~0.02).

Conclusion: Sexual dysfunction and sexual hormones level

reduction is common after on pump CABG. Complementary studies

are suggested for prevention and treatment of sexual dysfunction.

PP-268

EFFECT OF PHYLLOQUINONE ON DEXAMETHASONE

INDUCED CALCIFICATION OF HEART MUSCLE AND MEDIA

ELASTOCALCINOSIS IN AORTA ARTERY IN RAT MODEL:

A HYPOTHESIS FROM CARDIOVASCULAR SURGERY

M. Rezaeisadrabadi, S. Ghobadi, S.T. Zahir, S.A.H. Sayegh,

M.H.D. Rahmatabadi, M. Ahmadi, M. Lotfaliani, A. Mirjalili,

A. Rezaei. Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Background: Dexamethasone would enhance the rate of pericyte

differentiation and mineralization in vitro with concomitant

suppression of calcification inhibitory molecules matrix Gla-protein

(MGP). Vitamin k is an essential cofactor in carboxylation of

glutamate residues in a small group of proteins, including MGP.

This study attempting to assess the efficacy of vitamin k1 on

dexamethasone induced media elastocalcinosis in aorta artery and

heart muscle in rat model.