Vitamin D Treatment Attenuates Heart Apoptosis After Coronary Artery Bypass Surgery: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial

2020 ◽  
Vol 25 (4) ◽  
pp. 338-345 ◽  
Author(s):  
Erfan Tasdighi ◽  
Manouchehr Hekmat ◽  
Mahmoud Beheshti ◽  
Ramin Baghaei ◽  
Seyed Mohsen Mirhosseini ◽  
...  
Keyword(s):  
Vitamin D ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Inflammatory Status ◽  
Significant Difference

Background: Vitamin D plays an important role in immune system and in the regulation of inflammatory cytokines. Coronary artery bypass graft (CABG) with cardiopulmonary bypass (CPB) is associated with an extensive inflammatory response. The aim of this study is to examine the effect of vitamin D treatment on the apoptosis and inflammatory changes developed after CABG. Methods: This trial was conducted on 70 patients undergoing CABG with CPB. Patients were randomly administered either in placebo or in the group of orally consuming 150 000 IU vitamin D daily for 3 consecutive days before surgery. The right atrium sample was taken to assess caspases 2, 3, and 7 activity using immunohistochemistry method. The serum level of interleukin-10 (IL-10) and insulin-like growth factor 1 (IGF-1) were compared at intervals. Results: The average number of positive cells for caspases 2 and 3 were less in vitamin D group ( P = .006 and P < .001, respectively). There was an increase in serum levels of IL-10 after 3 days from vitamin D treatment before surgery (vitamin D group = 4.4 ± 4.9 ng/mL and control group = 1 ± 0.5 ng/mL, P = .001). After operation, IL-10 increased in both groups, higher level in vitamin D group ( P < .001). The comparison of serum IGF-1 showed significant difference after 3 days ( P = .006) and remained higher in vitamin D group after CPB ( P < .001). Conclusions: These findings suggest the apoptosis rate after CPB can be reduced by vitamin D. Vitamin D treatment may improve the inflammatory status before and after surgery. Further studies are needed to confirm the antiapoptotic property of vitamin D and clinical implication.

scholarly journals The effect of eucalyptus vapor on cough after coronary artery bypass surgery

2018 ◽  
Author(s):  
Somayeh Zare ◽  
Masoumeh Bagheri-Nesami ◽  
Hedayat Jafari ◽  
Jamshid Yazdani-Charati ◽  
Valiollah Habibi
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Controlled Trial ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Tracheal Extubation ◽  
Control Group ◽  
Significant Difference ◽  
And Control ◽  
Interventional Group

Cough is postoperative complication following endotracheal intubation as well as inflammation of the pharynx, larynx and trachea. The aim of this study was to evaluate the effect of eucalyptus vapor on cough after tracheal extubation in patients undergoing coronary artery bypass graft (CABG). In this randomized controlled trial, 100 patients undergoing CABG were randomly divided into two groups by accessible sampling. Before the intervention and after tracheal extubation, demographic and clinical data, as well as data on cough by a scoring system were collected from interventional and control groups. The patients in the interventional group after tracheal extubation were exposed to eucalyptus vapor for about 10 min. This treatment was performed at 1 and 12 h after extubation. The severity of cough was recorded in both interventional and control groups at 0, 1, 6, 12 and 24 h after extubation. The present study showed that the severity of cough after extubation in the patients undergoing CABG in the interventional group had no significant difference at the times of immediate to 24 hours after extubation. Risk of cough had respectively 9.5% increase in the control group as compared to the interventional group.

The effect of melatonin on interleukins 22 and 13 in patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass: A Clinical Trial

2020 ◽  
Author(s):  
Reza Jouybar ◽  
Mansour Jannati ◽  
Saeed Khademi
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
The Body ◽  
Control Group ◽  
Artery Bypass Graft ◽  
Significant Difference

Abstract Objective: Coronary artery bypass graft surgery with cardiopulmonary bypass (CABG) is one treatment for patients with coronary artery disease. After CABG, a series of inflammatory processes occur which affect other organs of the body and even cause severe organ damage and subsequently a worse prognosis. The purpose of this study was to evaluate the effect of pre-surgically administered melatonin on interleukins 22 and 13 in patients undergoing CABG.Results: In this study, 22 patients were evaluated, 10 patients (45.5%) in the Melatonin group, and 12 patients (54.5%) in the control group. The mean level of IL-22 at all time-points in T2, T3, and T4 was significantly lower in the Melatonin group (P <0.05). There was also a significant increase in IL-22 in both groups at T4 compared to T1. There was no significant difference between the two groups in IL-13 at any time, but the Melatonin group at T2 had a significant decrease in IL-13 compared to T1. This study showed that preoperative melatonin administration could prevent the increase of IL-22 but not IL-13.

scholarly journals Functional features of innate immunity in the development of postpericardiotomy syndrome in patients after coronary artery bypass grafting

2019 ◽  
Vol 10 (4) ◽  
pp. 71-79
Author(s):  
I. F. Shlyk ◽  
L. P. Sizyakina ◽  
R. V. Sidorov ◽  
S. V. Shlyk
Keyword(s):  
Innate Immunity ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Control Group ◽  
Natural Killers ◽  
Postpericardiotomy Syndrome ◽  
Group I ◽  
Functional Features

Objective: to study the functional characteristics of innate immunity in the formation of postpericardial syndrome (PPS) in patients undergoing coronary artery bypass graft ing (CABG).Materials and methods: the study involved 60 people, 40 of them made up the main group of patients with coronary artery disease, which retrospectively aft er 1 month of observation was divided into 2 groups. Group I CABG and PPS, group II CABG without PPS. The control group consisted of 20 patients without IHD. Before surgery, aft er 5, 14 days and 1 month, the expression of toll-like receptors (TLRs) 2, 4, 9, the content of CD16+ and Granzyme B lymphocytes, the HCT test and serum α-defensin were evaluated in blood cells. Statistical analysis of the results of the study was carried out using the program Statistica 12.0 (StatSoft , USA). The difference in mean values between groups was evaluated by the Mann-Whitney test. Statistical signifi cance was considered signifi cant at p ≤ 0.05.Results: when comparing the initial indices of the main groups and the control group, an increase in the expression of TLRs 2, 4, 9 was revealed. An increase in the content of CD16+, as well as an increase in the cytotoxic activity of natural killers and an increase in the production of α-defensin.Conclusions: on the basis of the study, activation of the cellular link of innate immunity, an increase in the cytotoxic potential of natural killers and a signifi cantly high level of α-defensin both before and aft er CABG were revealed, which can play an important role in the development of PPS. 

Increased Risk of Sternal Complications in Patients with Plasma Cell Dyscrasias (PCDs) Undergoing Coronary Artery Bypass Graft (CABG)

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5319-5319
Author(s):  
Malini M Patel ◽  
Shams B Bufalino ◽  
Anai N Kothari ◽  
Paul C Kuo ◽  
Sucha Nand
Keyword(s):  
Renal Failure ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Odds Ratio ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Control Group ◽  
Artery Bypass Graft ◽  
Increased Risk

Abstract Introduction: Skeletal events, including fractures, form an important part of the clinical spectrum of PCDs. Skeletal surveys, even though less sensitive than MRI, remain the usual method of screening for lytic lesions and fractures in these patients but may miss subtle abnormalities. Patients undergoing a CABG normally require a midline sternal incision, which may increase the risk of a skeletal event. Patients with PCDs also have an increased risk of infection, thrombosis, and renal failure. To our knowledge, there is no published data about complications of cardiothoracic surgery in these patients. We hypothesized that patients with PCDs will have a higher risk of complications when compared to those without such history. Methods: Data on patients who underwent non-urgent coronary artery bypass graft (CABG) surgery from 2007 to 2011 was obtained by querying the Healthcare Cost and Utilization State Inpatient Databases for Florida and California. Information was available only for the inpatient stay plus a 30-day follow-up period. Diagnoses of multiple myeloma and monoclonal gammopathy of unknown significance (MGUS) were identified using ICD-9-CM codes. Mixed-effects logistic models were used to measure the association between PCDs and postoperative sternal complications controlling for demographics and comorbidity. Secondary outcomes of study in bivariate analysis included postoperative complications and 30-day readmission rates. Results: A total of 54,422 patients who underwent non-urgent CABG were identified. Of those patients, 500 were known to have a PCD. Ninety two percent of those patients (462 out of 500) had a diagnosis of MGUS. Median age was 66.6 years for the control group and 65.4 years in the PCDs group, and the male to female ratio was equal in both cohorts. In the PCD group, there was a statistically significant higher incidence of anemia, obesity, and renal failure prior to surgical intervention. Sternal infections occurred in 519 (1%) of the patients in the control group versus 18 (3.6%) of the patients in PCDs group (p<0.001). The 30-day all cause readmission rate was similar between the two groups but the 30-day sternal complication rate was significantly higher in the PCDs group (6.8% vs 3.7%; p<0.001). The odds ratio of sternal infection was 3.84 (CI 2.38-6.20) and the odds ratio of sternal dehiscence was 3.87 (CI 1.98-7.57) in the PCDs group when compared to the control group, both of which are statistically significant. Similarly, the odds ratio of sternal complications at 30-days was 1.92 (CI 1.35-2.73) in the PCDs group when compared to the control group. There were no statistically significant differences in the rates of postoperative myocardial infarctions, strokes, urinary tract infections, acute kidney injury, pneumonias, deep venous thrombosis, and gastrointestinal complications between the two cohorts. Conclusions: Our data shows that patients with PCDs have a lower hemoglobin level, renal insufficiency, and are obese at the time of coronary bypass surgery. It is important to note that the majority of the subjects in our study population had MGUS, a condition usually associated with little morbidity. Nonetheless, our cohort of patients with PCDs had a significantly increased risk of sternal wound infection and dehiscence. The treating physicians should be aware of these risks and patients should be informed. Prospective studies will be necessary to confirm and extend these findings. Disclosures No relevant conflicts of interest to declare.

The effect of glutamate infusion on cardiac performance is independent of changes in metabolism in patients undergoing routine coronary artery bypass surgery

2001 ◽  
Vol 101 (6) ◽  
pp. 573-580 ◽  
Author(s):  
Chris J. LANGENBERG ◽  
Henk G. PIETERSEN ◽  
Gijs GESKES ◽  
Anton J.M. WAGENMAKERS ◽  
Simon DE LANGE ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Resistance Index ◽  
Controlled Study ◽  
Double Blind ◽  
Cabg Surgery ◽  
Esterified Fatty Acids

In a double-blind randomized placebo-controlled study, the effects of intravenous glutamate infusion on myocardial haemodynamics and metabolism were studied in 22 patients undergoing routine coronary artery bypass graft (CABG) surgery. Immediately after aortic cross-clamp release, an intravenous infusion of a solution of glutamate (125mmolċl-1) at a rate of 1.5mlċh-1ċkg-1 was given over 1h to 11 patients (G group). The other 11 patients received a placebo infusion (0.9% NaCl) (P group). Haemodynamic functions and rates of exchange of glucose, non-esterified fatty acids and lactic acid over the heart were measured before sternotomy (T1), 40min after cross-clamp release (T2) and 4h after cross-clamp release (T3). At T2, decreases were seen in comparison with T1 in systemic vascular resistance index, and increases were seen in cardiac index and coronary sinus flow. All of these changes were greater in the G group than in the P group (P < 0.05). Myocardial glutamate consumption increased 2-fold after glutamate administration. No significant changes were observed in the myocardial utilization of glucose, lactate or non-esterified fatty acids between the P and the G groups at T1, T2 or T3. These data show that an intravenous glutamate infusion after routine CABG surgery significantly improved cardiac haemodynamic performance without direct effects on cardiac substrate metabolism. This suggests that a reduction of the afterload via a peripheral vasodilatory effect is the main mechanism leading to the observed changes in haemodynamics. Earlier claims that patients with post-operative cardiac failure show metabolic benefits from the glutamate infusion do not seem to apply to patients undergoing routine CABG surgery.

scholarly journals Comparison of acute normovolemic hemodilution effect on the amount of bleeding in the first 48 hours after coronary artery bypass grafting

2018 ◽  
Vol 5 (6) ◽  
pp. 1417
Author(s):  
Vadoud Norouzi ◽  
Mohammad Hasanpour ◽  
Sahar Khajavi
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Blood Group ◽  
Artery Bypass ◽  
Control Group ◽  
Control Groups ◽  
Bleeding Volume ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Background: Cardiovascular disease is one of the most common causes of mortality in developed countries, as well as in the whole world. In this regard, autologous transfusion is a topic that can be useful and valuable, especially in complex surgery such as heart surgery and organ transplantation. One of its variants is Acute Normovolomic Hemodilution (ANH). Therefore, the aim of this study was to compare the effect of ANH on the amount of bleeding in the first 48hours after coronary artery bypass grafting.Methods: In this clinical trial, 100 patients were selected from all heart patients referred to Imam Khomeini Hospital in Ardebil for CABG surgery in the years 2016-17. They were selected by simple random sampling as a statistical sample and They were divided into intervention (50 ANH recipients’ people) and control groups (50 without ANH people).Results: Based on the findings, in the ANH recipients’ group, the mean of bleeding volume was 59.1±7.3ml in the first day and 55.6±4.2ml in the control group and the difference between the two groups was not significant on the first day. The mean of bleeding volume on the second day was 46.1±2.8ml in the ANH group and 42.7±2.9ml in the control group. Although it was somewhat higher, it was not statistically significant. Of all samples 45% were female and 55% were male. The most common type of blood group was 33 (33%) in the blood group O. The highest age group (61%) was over the 60 years old. The pump time varied with an average of 122.2±21.5minutes. The lowest value was PT 11 and the highest was 15 with an average of 13.02±0.9seconds. The mean of PTT was 32.5±2.6seconds and the mean INR was 1.1±1.0. The average plt was 251170±64124. The mean ACT was 596 / 6±183/7seconds.Conclusions: The results showed that in the mean of bleeding volume between the intervention and control groups (p = 0.41), bleeding volume by age (p = 0.3), bleeding volume by gender (p =0.54) and bleeding volume by blood group (p=0.48) was not significant difference. Based on these results, it is suggested that more studies be done on the more number of samples.

scholarly journals Blood Glucose Profile Post Coronary Artery Bypass Graft in Rsup H. Adam Malik Medan

2018 ◽  
Vol 5 (1) ◽  
pp. 3470-3472
Author(s):  
Farhan Syarif ◽  
Marshal . ◽  
Doddy Prabisma Pohan
Keyword(s):  
Blood Glucose ◽  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Glucose Level ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Significant Difference

Cardiopulmonary bypass (CPB) is widely used for systemic and oxygenated systemic settings during open heart surgery. (Simon L, 2004) To date there is yet to be found a definitive biochemical marker that can be considered prognostic in patients who subside. using a CPB machine. Hyperglycemia is defined as a glucose level above the normal physiological range. Normal blood glucose level is 70-120 mg and levels > 120 mg/dL is a diagnostic level for diabetes. During CPB and coronary artery bypass off-pump (OPCAB), most patients tend to have elevated blood glucose levels despite no previous diabetes medical history. This study uses a descriptive study design study with a retrospective approach. The study was conducted in the Division of Cardiac and Cardiac Surgery of the Department of Surgery of the Faculty of Medicine USU/ RSUP H. Adam Malik Medan. The study was conducted after the proposal was approved. The population in this study were patients who performed Coronary Artery ByPass Graft surgery using Cardiopulmonary Bypass (CBP) at RSUP H. Adam Malik Medan in 2016 (01 January - 31 December 2016). The study involved patients who performed Coronary Artery ByPass Graft surgery using a CPB machine in RS. Haji Adam Malik Medan. The number of research subjects was 41 people. . Based on sex it is seen that more men (84.3%) than women. The mean of postoperative KGD H + 3 was the highest KGD that was 218,28 + 23,5 mg / dL. The use of Humulin R is most commonly used in insulin therapy with patients with postoperative CPB hyperglycemia. Based on the ANOVA test there was a significant difference in the value of KGD in H + 1 post CPB operation compared to H + 2 post CPB operation (p = 0.013, p <0.05).

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