Objective: Hyperamylasemia is reported in 30–70% of cardiac surgery patients. The exact cause of elevated serum levels of amylase remains unclear. The goal of our study was to find out the possible cause of amylase elevation and evaluate the influence of increased levels of serum amylase on the postoperative course and clinical outcome of 110 cardiac surgical patients. Design: Prospective study. Setting: Cardiac Surgery Department, Prague General Hospital, 1st Medical Faculty of Charles University, Prague, the Czech Republic. Material and methods: The cohort of 110 randomly selected patients who underwent cardiac surgery at our institution was studied prospectively. Serial blood and urine samples were obtained on the 1st and 2nd morning after the operation. Pancreatic isoamylase, creatinine, the fractional clearence of pancreatic isoamylase (in relation to creatinine clearence) were measured. To preclude an important pancreatic cellular injury we used the semiquantitative urinary trypsinogen-2 dipstick test. Postoperatively we studied a clinical course of illness, start of feeding by oral route and time to discharge from postoperative ICU. Results: 22 out of 110 patients (20%) had at least one serum sample with elevated pancreatic isoamylase concentration.We observed no acute pancreatitis in our patients. Preoperative hyperamylasemia and perioperative hemodynamic insult were identified as independent predictors of postoperative hyperamylasemia leading probably to splanchnic hypoperfusion. Conclusion: Early elevation of pancreatic isoamylase after cardiac surgery procedure probably could not be interpreted as a sign of pancreatic cells injury and does not affect mortality or morbidity.

        Key words: amylases – pancreatitis – trypsinogen – cardiac surgery