Cytochrome c in patients undergoing coronary artery bypass grafting: A post hoc analysis of a randomized trial

• Published in: Journal of critical care 2017-12, Vol.42, p.248-254
• Main Authors: Andersen, Lars W., Liu, Xiaowen, Montissol, Sophia, Holmberg, Mathias J., Fabian-Jessing, Bjørn K., Donnino, Michael W.
• Format: Article
• Language: English
• Subjects: Cardiac surgery; Cell adhesion & migration; Coronary artery bypass grafting; Critical care; Cytochrome c; Evidence-based medicine; Heart surgery; Inflammation; Lactate; Mitochondrial DNA; Mortality; Oxygen consumption; Plasma; Tumor necrosis factor-TNF; Vascular endothelial growth factor
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2017.08.006

To establish whether plasma cytochrome c is detectable in patients undergoing cardiac surgery, whether cytochrome c levels are associated with lactate/inflammatory markers/cellular oxygen consumption, and whether cytochrome c levels are associated with clinical outcomes. This was an observational sub-study of a randomized trial comparing thiamine to placebo in patients undergoing coronary artery bypass grafting. Patients had blood drawn before, after, and again 6h after surgery. Cytochrome c, inflammatory markers, and cellular oxygen consumption were measured. 64 patients were included. Cytochrome c was detectable in 63 (98%) patients at baseline with a median cytochrome c level of 0.18ng/mL (quartiles: 0.13, 0.55). There was no difference from baseline level to post-surgical level (0.19ng/mL [0.09, 0.51], p=0.36) or between post-surgical level and 6-hour post-surgical level (0.17ng/mL [0.10, 0.57], p=0.61). There was no difference between the thiamine and placebo groups' change in cytochrome c levels from baseline to after surgery (p=0.22). Cytochrome c levels were not associated with lactate, inflammatory markers, cellular oxygen consumption, or clinical outcomes. Cytochrome c levels did not increase after cardiac surgery and was not associated with the degree of inflammation or clinical outcomes. •Plasma cytochrome c was detectable in patients undergoing cardiac surgery.•Cytochrome c levels did not increase after cardiac surgery.•Cytochrome c was not associated with the degree of inflammation or clinical outcomes.