Abstract: Objective　To investigate the correlation between total cholesterol (TC) levels and the development of the early cardiac insufficiency in patients after off-pump coronary artery bypass grafting (OPCAB). Methods　A total of 201 patients who underwent OPCAB were retrospectively analyzed. Patients were divided into the cardiac insufficiency group (with the occurrence of early postoperative cardiac insufficiency, n=22) and the control group (without early postoperative cardiac insufficiency, n=179) according to the diagnostic criteria of early postoperative cardiac insufficiency. The laboratory and clinical data were collected. The preoperative clinical baseline data were compared between the 2 groups. The relevant study factors with statistically significant differences were included in a multifactorial dichotomous Logistic regression analysis to analyze the factors influencing the occurrence of the early postoperative cardiac insufficiency in patients after OPCAB. The predictive value of influencing factors was analyzed using the subject work characteristic (ROC) curve. Results　There were no significant differences in age, gender, body mass index (BMI), glucose, systolic blood pressure, preoperative left ventricular ejection fraction (LVEF), number of transplanted vessels, smoking, history of myocardial infarction and history of cerebral infarction between the cardiac insufficiency group and the control group (P＞0.05), and there were significant differences in baseline TC, triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels between the two groups (P＜0.05). The results of dichotomous Logistic regression analysis showed that the elevated TC level was a risk factor for the development of early postoperative cardiac insufficiency in OPCAB patients (OR=11.842, 95%CI: 4.055-34.580, P＜0.01). The area under the ROC curve AUC was 0.974 (95%CI: 0.954-0.994). The sensitivity was 0.955 and specificity was 0.922. Conclusion　Serum TC level can effectively predict the occurrence of early cardiac insufficiency in patients undergoing OPCAB, and the higher the serum TC level, the greater the likelihood of early postoperative cardiac insufficiency.

Key words: coronary artery bypass, off-pump, risk factors, total cholesterol, early cardiac insufficiency