IJCS | Volume 32, Nº2, May/June 2019

271 Table 1 - Baseline characteristics n (%) Age a (years) 69.3 ± 5 Male gender 18 (100) Sedentary lifestyle 18 (100) Alcohol consumption 2 (11.1) Smoking 11 (61.1) NYHA class II 14 (77.8) III 4 (22.2) Comorbidities Hypertension b 16 (88.8) Type 2 diabetes c 8 (44.4) Dyslipidemia d 9 (50.0) Previous myocardial infarction 9 (50.0) Drugs used Antidiabetic drugs 8 (44.4) Lipid-lowering drugs 16 (88.8) Antihypertensive drugs 16 (88.8) Diuretics 14 (77.8) Beta-blockers 9 (50.0) Vasodilators 15 (83.3) a Mean ± standard deviation. b On therapy. or resting blood pressure > 139/90 mmHg. 3 c On therapy. or fasting blood sugar > 126 mg/dL. 4 d Total cholesterol ≥ 239 mg/dL and triglycerides ≥ 150 mg/dL. 5 Table 2 - Anthropometric and biochemical evaluation in the preoperative and postoperative periods of coronary artery bypass grafting Parameters Preoperative Postoperative p-value BMI (kg/m²) a 28.4 ± 3.0 (overweight) 27.9 ± 2.9 (normal weight) 0.106* AMC (cm) a 28.0 ± 2.2 102.9% (normal weight) 26.8 ± 2.1 98.5% (normal weight) 0.007* TS (mm) a 15.6 ± 4.2 125.8% (obesity) 15.7 ± 5.3 126.6% (obesity) 0.973* WC (cm) b 102.0 [99.33-104.3] 102.4 [99.4-105.8] 0.412** BF (%) b 34.23 [30.8-36.8] ( ↑ risk) 34.0 [31.7-36.5] ( ↑ risk) 0.6514** Albumin (g/dL) a 4.0 ± 1.0 ( ↓ risk) 3.0 ± 0.8 (medium risk) < 0.00* a Mean ± standard deviation; b Median and interquartile range. *Paired t test. **Mann-Whitney test. BMI: body mass index; AMC: arm muscle circumference; TS: triceps skinfold; WC: waist circumference; BF: (%) body fat percentage; Serum albumin. Costa et al. Effect of surgery on loss of muscle mass Int J Cardiovasc Sci. 2019;32(3)269-273 Original Article are scarce. We have evidenced the impact of elective CABG on skeletal muscle mass reduction through anthropometry on the seventh postoperative day in patients with ischemic HF. This is a simple, low-cost method of assessing body composition. Major surgeries, such asCABG, cause a hypermetabolic state and systemic inflammatory stimulus, due to the release of hormones and cytokines 3 that may justify the loss of muscle mass observed in this study. Iida et al., 1 suggested surgical stress, extracorporeal circulation, and perioperative hypothermia as causes of musclemass loss. The muscle proteolysis after CABG in HF patients has been reported in studies that used biochemical parameters as an evaluation method. Iida et al., 1 have identified protein hypercatabolism through serum IL- 6, cortisol, insulin-like growth factor (IGF)-1, growth hormone, branched-chain amino acid, and aromatic amino acid levels and evaluated muscle proteolysis through the urinary ratio between 3-methylhistidine and creatinine. 3 They verified that muscle proteolysis was accelerated 24 hours postoperatively and suggested that interventions to preserve skeletal muscle mass should be carried out up to 48 hours after surgery. These findings suggested that muscle protein degradation was due to the metabolic response to surgical stress. The inflammatory stimulus provoked by surgery also justifies the significant reduction in albumin levels observed in this study. It is known that albumin is a visceral protein that has its concentrations reduced at the expense of increased expression of inflammatory proteins, such as C-reactive protein. Despite being a biochemical marker widely used to assess nutritional risk, there are limitations for its use in inflammatory processes. 3 Thus, the use of serumalbumin as an indicator