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

Table 1 Contents of the nutritional supplement drink (per 120 mL)

Contents
Agkistrodon meat and bones tincture	100 mg
Civet tincture	250 mg
Ginseng fluid extract	600 mg
Hawthorn flower extract	30 mg
Rehmannia root extract	120 mg
Royal jelly	100 mg
Vitamin B1 nitrate	10 mg
Vitamin B2 phosphate ester	5 mg
Vitamin B6	10 mg
Tocopherol acetate	10 mg
Nicotinamide	25 mg
Panthenol	10 mg
Chondroitin sulfate sodium	120 mg

Table 2 Patient characteristics

	CTL	YKR	P value
Number of patients	130	99
Age, yr	69.4 ± 0.8	68.5 ± 1.0	0.437
Female (%)	20 (15.4)	12 (12.1)	0.481
BMI	24.5 ± 0.3	24.7 ± 0.3	0.644
Hypertension (%)	90 (69.2)	74 (74.7)	0.360
Diabetes mellitus (%)	70 (53.8)	49 (49.5)	0.407
Dyslipidemia (%)	94 (72.3)	75 (75.8)	0.791
Smoking history (%)	78 (60.0)	59 (59.6)	0.950
Preoperative AF (%)	4 (3.1)	1 (1.0)	0.261
NYHA	1.6 ± 0.1	1.7 ± 0.1	0.725
LAD, mm	37.3 ± 0.4	37.9 ± 0.5	0.316
LVDd, mm	47.8 ± 0.5	49.1 ± 0.7	0.131
LVDs, mm	32.0 ± 0.6	32.7 ± 0.8	0.537
IVST, mm	9.7 ± 0.1	9.9 ± 0.1	0.266
PWT, mm	9.8 ± 0.1	10.0 ± 0.1	0.195
LVEF, %	61.0 ± 0.8	60.0 ± 1.4	0.540
Operation time, min	253.6 ± 5.7	248.4 ± 6.8	0.555
Intubation time, h	6.7 ± 0.7	5.6 ± 0.4	0.176
Number of distal anastomosis	3.2 ± 0.1	3.2 ± 0.1	0.964
Right gastroepiploic artery graft (%)	66 (50.8)	52 (52.5)	0.793
Saphenous vein graft (%)	47 (36.2)	32 (32.3)	0.470
Blood transfusion (%)	23 (17.7)	19 (19.2)	0.662
Postoperative AF (%)	31 (23.8)	24 (24.2)	0.936
ICU stay, d	1.2 ± 0.0	1.2 ± 0.0	0.895
Hospital stay, d	10.1 ± 0.3	10.7 ± 0.4	0.187

AF: Atrial fibrillation; BMI: Body mass index; ICU: Intensive care unit; IVST: Interventricular septum thickness; LAD: Left atrium diameter; LVDd: Left ventricular diastolic diameter; LVDs: Left ventricular systolic diameter; LVEF: Left ventricular ejection fraction; NYHA: New York Heart Association classification; PWT: Posterior wall thickness; CTL: Control group; YKR: Yunker group.

Table 3 Perioperative blood test results

	Group	Pre	P value	2 POD	P value	7 POD	P value	7-2 POD	P value
WBC, × 109/L	CTL	6.1 ± 0.3	0.991	12 ± 0.3	0.962	7.6 ± 0.2	0.534	-4.4 ± 0.2	0.568
	YKR	6.1 ± 0.2		12 ± 0.4		7.8 ± 0.2		-4.2 ± 0.3
Hb, g/dL	CTL	13.3 ± 0.1	0.645	11.2 ± 0.1	0.876	11.7 ± 0.1	0.130	0.5 ± 0.1	0.027a
	YKR	13.4 ± 0.2		11.3 ± 0.1		11.5 ± 0.1		0.2 ± 0.1
Hct, %	CTL	39.2 ± 0.4	0.315	33.3 ± 0.3	0.854	34.6 ± 0.3	0.194	1.3 ± 0.2	0.053
	YKR	39.8 ± 0.5		33.4 ± 0.4		34.0 ± 0.4		0.6 ± 0.3
TP, g/dL	CTL	6.8 ± 0.0	0.616	5.7 ± 0.0	0.904	6.1 ± 0.1	0.789	0.4 ± 0.1	0.684
	YKR	6.8 ± 0.0		5.7 ± 0.1		6.2 ± 0.1		0.5 ± 0.0
Alb, g/dL	CTL	4.0 ± 0.0	0.482	3.5 ± 0.0	0.337	3.4 ± 0.0	0.385	-0.1 ± 0.0	0.821
	YKR	4.0 ± 0.0		3.5 ± 0.0		3.3 ± 0.0		-0.1 ± 0.0
ChE, IU/L	CTL	301.7 ± 6.9	0.953	176.3 ± 4.0	0.258	183.0 ± 4.0	0.227	6.7 ± 2.4	0.934
	YKR	302.3 ± 7.8		183.3 ± 4.7		190.5 ± 4.6		7.0 ± 2.3
CK, IU/L	CTL	101.3 ± 6.9	0.565	482.4 ± 22.7	0.443	67.8 ± 5.3	0.736	-391.7 ± 16.9	0.878
	YKR	95.3 ± 7.6		458.0 ± 19.8		70.2 ± 4.3		-387.8 ± 18.2
ALP, IU/L	CTL	217.2 ± 6.1	0.491	142.7 ± 3.1	0.734	201.4 ± 6.0	0.103	58.7 ± 5.3	0.097
	YKR	210.8 ± 6.9		141.0 ± 4.1		222.8 ± 13.0		81.9 ± 12.8
T-Bil, mg/dL	CTL	0.8 ± 0.1	0.194	1.2 ± 0.1	0.100	0.9 ± 0.0	0.580	-0.3 ± 0.1	0.123
	YKR	0.7 ± 0.0		1.0 ± 0.1		0.8 ± 0.1		-0.2 ± 0.0
AST, IU/L	CTL	21.8 ± 0.7	0.133	28.9 ± 0.9	0.748	20.1 ± 0.9	0.245	-8.8 ± 1.1	0.556
	YKR	23.6 ± 1.0		29.3 ± 1.0		21.6 ± 0.8		-7.9 ± 1.0
ALT, IU/L	CTL	21.4 ± 1.1	0.388	16.4 ± 1.0	0.543	20.3 ± 1.2	0.101	3.9 ± 1.3	0.244
	YKR	23.1 ± 1.6		17.4 ± 1.3		23.7 ± 1.7		6.2 ± 1.5
γGTP, IU/L	CTL	33.1 ± 2.0	0.352	24.3 ± 1.3	0.555	38.2 ± 3.2	0.540	14.0 ± 2.7	0.489
	YKR	36.0 ± 2.5		25.5 ± 1.6		41.4 ± 3.9		16.9 ± 3.2
BUN, mg/dL	CTL	16.8 ± 0.5	0.814	20.6 ± 0.5	0.667	17.7 ± 0.8	0.619	-2.9 ± 0.7	0.840
	YKR	16.6 ± 0.6		21.0 ± 0.7		18.3 ± 1.0		-2.7 ± 0.9
Cre, mg/dL	CTL	0.9 ± 0.0	0.606	1.0 ± 0.0	0.954	1.0 ± 0.1	0.828	0.0 ± 0.0	0.633
	YKR	0.9 ± 0.0		1.0 ± 0.0		0.9 ± 0.0		0.0 ± 0.0
eGFR	CTL	72.1 ± 1.9	0.219	68.0 ± 2.2	0.688	68.2 ± 2.0	0.816	0.2 ± 1.1	0.726
	YKR	68.7 ± 2.0		66.7 ± 2.3		67.5 ± 2.3		0.8 ± 1.3
Na, mmol/L	CTL	140.9 ± 0.2	0.752	140.9 ± 0.3	0.269	140.7 ± 0.2	0.604	-0.2 ± 0.3	0.101
	YKR	140.8 ± 0.3		140.4 ± 0.3		140.9 ± 0.3		0.5 ± 0.3
K, mmol/L	CTL	4.3 ± 0.0	0.768	4.1 ± 0.0	0.416	3.9 ± 0.0	0.792	-0.1 ± 0.3	0.360
	YKR	4.3 ± 0.0		4.1 ± 0.0		3.9 ± 0.0		0.2 ± 0.3
CRP, mg/dL	CTL	0.3 ± 0.1	0.407	15.7 ± 4.4	0.176	3.8 ± 2.4	0.586	-11.9 ± 4.0	0.233
	YKR	0.4 ± 0.1		14.9 ± 4.4		3.7 ± 1.8		-11.2 ± 4.1
BNP, pg/mL	CTL	90.4 ± 15.8	0.692	346.0 ± 30.1	0.554	264.0 ± 23.6	0.881	-72.0 ± 12.6	0.653
	YKR	99.0 ± 13.3		321.6 ± 24.5		258.6 ± 27.4		-63.0 ± 15.7

^aP < 0.05. Alb: Albumin; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BNP: Brain natriuretic peptide; BUN: Blood urea nitrogen; ChE: Cholinesterase; CK: Creatine kinase; Cre: Creatinine; CRP: C-reactive protein; eGFR: Estimated glomerular filtration rate; γGTP: Gamma-glutamyl transpeptidase; Hb: Hemoglobin: Hct: Hematocrit; K: Potassium; Na: Sodium; T-Bil: Total bilirubin; TP: Total protein; WBC: White blood cells; POD: Postoperative day; CTL: Control group; YKR: Yunker group.

Table 4 Number of positive patients in the Hospital Anxiety and Depression Scale and Geriatric Depression Scale-15 tests

	Group	Pre (%)	Post (%)	Pre vs post	Improve	Worsen
HADS_A (≥ 11)	CTL	74 (85.1)	82 (94.3)	< 0.05	3 (3.4)	11 (12.6)
	YKR	50 (87.7)	50 (87.7)	1.00	4 (7.0)	4 (7.0)
HADS_D (≥ 11)	CTL	31 (35.6)	43 (49.4)	< 0.05	7 (8.0)	19 (21.8)
	YKR	29 (50.9)	23 (40.4)		14 (24.6)	9 (15.8)
GDS (≥ 5)	CTL	26 (28.3)	25 (27.2)		10 (10.9)	9 (9.8)
	YKR	14 (23.7)	12 (20.3)		6 (10.5)	3 (5.3)

GDS: Geriatric Depression Scale-15; HADS_A: Anxiety scale of Hospital Anxiety and Depression Scale; HADS_D: Depression scale of Hospital Anxiety and Depression Scale; CTL: Control group; YKR: Yunker group.