Nutritional supplement drink reduces inflammation and postoperative depression in patients after off-pump coronary artery bypass surgery

Figure 1 Flow diagram of the study. OPCAB: Off-pump coronary artery bypass.

Figure 2 Perioperative activity was assessed using an accelerometer. A: Daily steps increased significantly in Yunker group postoperatively (P < 0.05), while control group (CTL) did not reach statistical differences (P = 0.096); B: Total activity increased significantly in both groups (P < 0.01, respectively); C: Moderate-to-vigorous intensity physical activity (MVPA) tended to decrease in both groups, although there were no significant differences; D: The ratio of the MVPA to the total activity was decreased in the CTL group. By contrast, it increased in the Yunker group, although no statistically significant differences were found in both groups. MET: Metabolic equivalent; MVPA: Moderate-to-vigorous intensity physical activity; CTL: Control group; YKR: Yunker group.

Figure 3 The levels of cytokines in serum and urine are shown. A: Interleukin-6 decreased significantly at 7^th postoperative day in both groups (P < 0.01), although there were no differences between the two groups; B: Tumor necrosis factor-alpha level was significantly lower in the Yunker group (P < 0.05); C: Adiponectin increased significantly in both groups, while there were no differences between the groups; D: No significant differences were observed in the levels of superoxide dismutase in both groups; E The ratio of urine 8-hydroxy-2’-deoxyguanosine and creatinine decreased significantly in both groups, while there were no differences between the groups. ^aP < 0.05; ^bP < 0.01. TNF-α: Tumor necrosis factor-alpha; SOD: Superoxide dismutase; 8-OHDG/Cre: 8-Hydroxy-2’-deoxyguanosine and creatinine; CTL: Control group; YKR: Yunker group.

Figure 4 Perioperative anxiety and depression levels were assessed using the Hospital Anxiety and Depression Score and Geriatric Depression Scale-15. A and B: The control group showed significant increase in anxiety scale of Hospital Anxiety and Depression Scale (A) and depression scale of Hospital Anxiety and Depression Scale (B) postoperatively (P < 0.01 and P < 0.05, respectively), while Yunker (YKR) group showed no statistical differences; C: Geriatric Depression Scale-15 showed no significant differences between the groups; D: While comparing the changes in the scores pre- and postoperatively, the HADS_D score was significantly decreased in the YKR group (P < 0.05). HADS_A: Anxiety scale of Hospital Anxiety and Depression Scale; HADS_D: Depression scale of Hospital Anxiety and Depression Scale; GDS: Geriatric Depression Scale-15; CTL: Control group; YKR: Yunker group.