Author/Authors :
Mirmansouri Ali نويسنده , Haghighi Mohammad نويسنده , Imantalab Vali نويسنده Fellowship of Cardiac Anesthesia, Assistant Professor of Guilan University of Medical Sciences, Department of Cardiac Anesthesia, Heshmat Hospital , Sedighinejad Abbas نويسنده استاديار بيهوشي، فلوشيپ بيهوشي قلب، دانشگاه علوم پزشكي گيلان، بيمارستان پورسينا، بخش بيهوشي صديقي نژاد عباس , Naderi Nabi Bahram نويسنده Department of Anesthesiology, Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran , Biazar Gelareh نويسنده Department of Anesthesiology, Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran , Mohammadzadeh Jouryabi Ali نويسنده MD, Associate Professor of Anesthesiology, Fellowship of Anesthesia in Cardiac Surgery, Guilan University of Medical Sciences, Rasht, IR Iran , Nassiri Sheikhani Nassir نويسنده MD, Assistant Professor of Cardiac Surgery, Department of Cardaic Surgery, Guilan University of Medical Sciences, Rasht, IR Iran , Atrkarroushan Zahra نويسنده PhD, Assistant Professor of Biostatistic, Guilan University of Medical Sciences (GUMS), Rasht, IR Iran
Abstract :
Background In patients with coronary artery stenosis, coronary
artery bypass graft surgery (CABG) is the most effective strategy to
limit infarct size and improving outcomes. However, the rapid restoring
of blood flow to the tissue can paradoxically induce cardiac damage.
This phenomenon termed as myocardial ischemic/reperfusion (I/R) injury
which is exacerbated under cardiopulmonary bypass (CPB) and is the cause
of poor clinical outcomes. Therefore, it is essential to search for
novel strategies with further cardio protective effects. Objectives In
the current study, we investigated the effects of selenium (Se)
administration on I/R injury in CABG patients. Methods This randomized
double-blind clinical trial was conducted in the department of cardiac
surgery of a university hospital in North of Iran from May 2015 to
September 2015. One hundred and ten patients undergoing an elective
isolated CABG surgery were divided into two groups using randomized
fixed quadripartite blocks. They received either intravenous Se before
induction of anesthesia, or normal saline as placebo. Cardiac troponin I
(CTnI) and creatine kinase-MB (CKMB) were measured as biomarkers at four
measurement point times, before the intervention (T0), at 6, 12, 24 and
48 hours after the surgery (T1-T4). Results Finally, data from 104
patients were analyzed, the Se (n = 53) and control (n = 51) groups.
There was no significant difference between the two groups regarding the
baseline characteristics. In both groups CPB caused a markedly increase
in CKMB and CTnI plasma concentrations compared to the baseline (P =
0.0001). Based on CKMB, there was no significant difference between the
two groups at any point times, T0 (P = 0.357), T1 (P = 0.751), T2 (P =
0.46), T3 (P = 0.16) and T4 (P = 0.053). According to CTnI, there was
just a significant difference between the two groups at T1 (P = 0.011)
but not at T2 (P = 0.116), T3 (P = 0.09) and T4 (P = 0.634). No adverse
effect was recorded linked to our intervention. Conclusions Selenium can
alleviate I/R injury in short time. Further well-planned trials are
needed to find the optimized administration method to achieve the most
beneficial effects to the patients.
