Document Detail


Cardioprotective effect of aprotinin on myocardial ischemia/reperfusion injury during cardiopulmonary bypass.
MedLine Citation:
PMID:  17062966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aprotinin is a serine protease inhibitor used extensively in cardiac operations to reduce postoperative bleeding. It also has cardioprotective effects in ischemia/reperfusion injury. In this study, the effects of aprotinin on the release of cardiac markers were evaluated in patients who had good ventricular function and were undergoing coronary artery bypass grafting with cardiopulmonary bypass (CPB). METHODS AND RESULTS: Eighty male patients with an ejection fraction >or=40%, were randomized into either an aprotinin (Group-I; n=40) or control (Group-II; n=40) group. Patients in the aprotinin group received the full Hammersmith doses of aprotinin (2 x 10(6) KIU pre-CPB, 2 x 10(6) KIU at pump prime, 500,000 KIU/h during CPB), whereas the patients in the control group received only saline solutions. Cardiac troponin-I (cTnI) levels were measured before surgery, immediately after surgery, and at postoperative 6(th), 12(th), 24(th) h and 5(th) day. Creatine kinase (CK)-MB measurements were performed at the same time except for the postoperative 5(th) day. Cardiac index (CI), mixed venous oxygen saturation and lactate dehydrogenase (LDH) measurements were also performed. CONCLUSION: Although all patients were in reasonable condition, less myocardial enzyme leakage occurred on the aprotinin group, suggesting that aprotinin has a protective effect on the myocardium beyond that achieved with blood cardioplegia and systemic hypothermia. Because of aprotinin's effects on multiple targets of metabolism, its protective value might increase in more complicated cases.
Authors:
Pelin Karaca; Cüneyt Konuralp; Yavuz Enc; Asuman Süzer; Onur Sokullu; Umut Ayoglu; Sertac Cicek
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  70     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-25     Completed Date:  2006-12-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1432-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Reanimation, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aprotinin / pharmacology,  therapeutic use*
Cardiopulmonary Bypass / methods*
Coronary Artery Disease / surgery
Creatine Kinase, MB Form / blood
Double-Blind Method
Heart / drug effects,  physiopathology
Heart Arrest, Induced / adverse effects
Humans
Hypothermia / physiopathology
L-Lactate Dehydrogenase / blood
Male
Middle Aged
Prospective Studies
Reperfusion Injury / blood,  drug therapy*,  physiopathology,  prevention & control
Serine Proteinase Inhibitors / pharmacology,  therapeutic use*
Troponin T / blood
Chemical
Reg. No./Substance:
0/Serine Proteinase Inhibitors; 0/Troponin T; 9087-70-1/Aprotinin; EC 1.1.1.27/L-Lactate Dehydrogenase; EC 2.7.3.2/Creatine Kinase, MB Form

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