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Title: Aprotinin reduces cardiac troponin I release and inhibits apoptosis of polymorphonuclear cells during off-pump coronary artery bypass surgery
Authors: Bert, Christophe ×
De Buck, Frederik
Sergeant, Paul
Van Hemelrijck, Jan
Kasran, Ahmad
Van Duppen, Victor
Ceuppens, Jan
Meyns, Bart
Delforge, Michel
Wouters, Patrick #
Issue Date: Feb-2008
Publisher: W.B. Saunders
Series Title: Journal of Cardiothoracic and Vascular Anesthesia vol:22 issue:1 pages:16-22
Abstract: Objectives: In addition to blood-sparing effects, aprotinin may have cardioprotective and anti-inflammatory effects during cardiopulmonary bypass-assisted cardiac surgery. In this study, the authors examined whether aprotinin had cardioprotective and/or anti-inflammatory effects in patients undergoing off-pump coronary artery bypass grafting. Design: A prospective randomized clinical trial. Setting: University hospital. Participants: Fifty patients were randomized to control (n = 25) or aprotinin treatment (n = 25) groups. Interventions: Aprotinin was given as a loading dose (2 x 10(6) KIU) followed by a continuous infusion at 5 x 10(5) KIU/h until skin closure. Measurements and Main Results: Blood samples for cardiac troponin I; interleukin-6, interleukin-8, and interleukin-10; tumor necrosis factor a; and elastase were taken after anesthesia induction, completion of revascularization, and 6 hours, 12 hours, and 24 hours after revascularization. Blood samples were taken to assess for apoptosis in polymorphonuclear cells. Baseline plasma levels for cardiac troponin I did not differ between groups but were significantly lower in aprotinin-treated patients at the time of revascularization (P = 0.03) and 6 hours (p = 0.004) and 24 hours (p = 0.03) later. Aprotinin significantly reduced apoptosis in polymorphonuclear cells compared with control-treated patients (p = 0.04). There were no differences in plasma cytokine or elastase levels between groups. Conclusions: The authors conclude that aprotinin reduces perioperative cardiac troponin I release and attenuates apoptosis in polymorphonuclear cells but has no significant effects on plasma cytokine levels in patients undergoing off-pump coronary artery bypass graft surgery. (c) 2008 Elsevier Inc. All rights reserved.
URI: 
ISSN: 1053-0770
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Anesthesiology and Algology
Laboratory of Clinical Immunology
Clinical Cardiac Surgery
Embryo and Stemcells (-)
× corresponding author
# (joint) last author

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