Işıl Taşöz ÖZDAŞ, Ertan DEMİRDAŞ, Muharrem Emre ÖZDAŞ, Bilgehan Savaş ÖZ, Celalettin GÜNAY, Kubilay KARABACAK, Murat KADAN, Cengiz BOLCAL
Türk Göğüs Kalp Damar Cerrahisi Dergisi - 2026;34(2):130-137
Background: Cardiac surgery has seen significant improvements, but reducing complications like vasoplegic syndrome remains a priority. Vitamin B12 is emerging as a treatment for vasoplegia. We investigated if preoperative serum vitamin B12 levels could predict the need for postoperative inotropic support in patients undergoing coronary artery bypass grafting (CABG). Methods: This was a retrospective study of 166 patients who underwent isolated elective conventional CABG between 2019 and 2023. We collected patient demographics, comorbidities, and preoperative vitamin B12 levels. Postoperative data on the need for inotropic agents (adrenaline, dopamine, dobutamine) and cardiac assist devices were also analyzed. Mann-Whitney U tests with Bonferroni correction for multiple comparisons and multivariable logistic regression adjusting for confounders were performed. Results: Patients who required adrenaline, dopamine, or dobutamine support had significantly lower median preoperative vitamin B12 levels compared to those who did not. Specifically, adrenaline-dependent patients had a median B12 level of 97.00 (84.00-107.00) pg/mL, while non-dependent patients had 259.00 (187.50-385.00) pg/mL (p<0.001, effect size r=0.87). After Bonferroni correction, low B12 levels remained significantly associated with adrenaline (p<0.001) and dopamine (p=0.0005) requirements. In multivariable analysis adjusting for age, sex, left ventricular ejection fraction, comorbidities, and operative times, vitamin B12 remained independently associated with adrenaline requirement (odds ratio=0.781 per 10 pg/mL, 95% confidence interval: 0.708-0.861, p<0.001). Conclusion: Low preoperative serum vitamin B12 levels are independently associated with the need for postoperative inotropic support after CABG, particularly adrenaline requirement. These findings suggest that preoperative B12 levels may be a valuable predictive marker for identifying high-risk patients and could guide prophylactic strategies. Further research is needed to explore this relationship in more detail.
