Document Detail


Deferoxamine infusion during coronary artery bypass grafting ameliorates lipid peroxidation and protects the myocardium against reperfusion injury: immediate and long-term significance.
MedLine Citation:
PMID:  15618054     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Previous reports have demonstrated enhanced myocardial protection and better post-ischaemic recovery using the oxygen free radical scavenger deferoxamine (DEF) during cardioplegia. The aim of this study was to test whether, in patients undergoing coronary artery bypass grafting (CABG), DEF i.v. infusion can reduce reperfusion injury on a short- and long-term basis. METHODS AND RESULTS: Forty-five consecutive male patients were randomly allocated to two groups: in group D (n=25, age 60.8+/-8.6 years), 4 g of DEF were infused for 8 h starting immediately after the induction of anaesthesia; in group C (n=20, age 62.2+/-6.4 years) dextrose solution was given for the same time as placebo. Haemodynamic monitoring and measurement of oxygen free radical production [by measuring thiobarbituric acid reactive substances (TBARS)] were carried out before and after CABG. Left ventricular ejection fraction (EF) and wall motion score index (WMSI) were measured before and after CABG and 12 months later. Haemodynamic measurements were similar in both groups before and after CABG. TBARS peaked at 4.8+/-1.1 nmol/mL in group C, but remained unchanged (2.4+/-0.9 nmol/mL) in group D (P=0.01). At baseline, both the EF and WMSI were similar between the groups. Following CABG, EF increased more in group D (8.8+/-8.4%) than in group C (1.3+/-6.7%), P=0.008, while WMSI decreased more in group D (-0.7+/-0.3) than in group C (-0.2+/-0.2), P=0.0001. Dividing group D according to the pre-operative median EF value (38%), we observed that after 1 year follow-up, DEF infusion conferred more protection in patients with a lower EF (EF increased by 19.3+/-6.2%, WMSI decreased by -1.1+/-0.2) than in those with a higher EF (EF increased by 7.7+/-4.5%, WMSI decreased by -0.8+/-0.2), P=0.001, respectively. CONCLUSION: In patients undergoing CABG, DEF i.v. infusion ameliorates oxygen free radical production and protects the myocardium against reperfusion injury. Patients with a lower EF seem to benefit more by DEF i.v. infusion.
Authors:
Ioannis A Paraskevaidis; Efstathios K Iliodromitis; Demetrios Vlahakos; Dimitrios P Tsiapras; Athanassios Nikolaidis; Aikaterini Marathias; Alkiviadis Michalis; Dimitrios Th Kremastinos
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial     Date:  2004-11-30
Journal Detail:
Title:  European heart journal     Volume:  26     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-21     Completed Date:  2005-04-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  263-70     Citation Subset:  IM    
Affiliation:
2nd Department of Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, 176 74 Athens, Greece. iparas@otenet.gr
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass / methods*
Coronary Artery Disease / surgery
Deferoxamine / administration & dosage*
Echocardiography, Transesophageal
Humans
Infusions, Intravenous
Intraoperative Care / methods
Iron Chelating Agents / administration & dosage*
Lipid Peroxidation / drug effects*
Long-Term Care
Male
Middle Aged
Myocardial Reperfusion Injury / prevention & control*
Myocardial Stunning / etiology
Chemical
Reg. No./Substance:
0/Iron Chelating Agents; 70-51-9/Deferoxamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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