Author/Authors :
Ercan, Abdulkadir Özel Balıkesir Hastanesi - Kalp ve Damar Cerrahisi, Turkey , Velioğlu, Yusuf Özel Balıkesir Hastanesi - Kalp ve Damar Cerrahisi, Turkey , Ercan, Arzu Özel Bahar Hastanesi - Kalp ve Damar Cerrahisi, Turkey , Gürbüz, Orçun Eğitim Araştırma Hastanesi - Kalp ve Damar Cerrahisi, Turkey , Özkan, Hakan Özel Medikal Park Hastanesi - Kardiyoloji, Turkey , Karal, İlker Hasan Uludağ Üniversitesi - Tıp Fakültesi - Kalp ve Damar Cerrahisi AD, Turkey , Biçer, Murat Uludağ Üniversitesi - Tıp Fakültesi - Kalp ve Damar Cerrahisi AD, Turkey , Ener, Serdar Özel Acıbadem Hastanesi - Kalp ve Damar Cerrahisi, Turkey
Abstract :
Objectives: This prospective, randomised, controlled, clinical study was planned to determine the effect of trimetazidine and glucose - insulin - potassium (GIK) on myocardial ischemia-reperfusion during beating heart coronary artery bypass surgery. Materials and methods: Patients (n=45) with coronary artery disease who required beating heart coronary artery bypass grafting were randomly allocated into three groups. Patients in group 1 (n=15) was recevied trimetazidine (20 mg x 3 per day) 7 days before surgery. Patients in group 2 (n=15) received GIK infusion after induction of anesthesia through the first 12 hours of intensive care unit convalescence. Patients in group 3 (n=15) were control group. Measurements of blood glucose, circulating creatine kinase MB (CK-MB) and Troponin I (TnI) concentrations were obtained before surgery, 5 minutes after completion of operation and at 12, 24, and 48 hours postoperatively. Mean pulmonary artery pressure, cardiac index, morbidity and data associated with operation were recorded in all patients preoperatively and postoperatively. Results: Preoperative risk profiles and operative variables were statistically similar when the groups were compared. The concentration of circulating CK-MB and Tn I significantly increased over time after off - pump coronary artery surgery, with no significant intergroup differences. Cardiac index and mean pulmonary artery pressure did not differ significantly between groups. Conclusion: Pretreatment with trimetazidine and GIK infusion protocol were used as an adjunct to ischemic - reperfusion therapy in off - pump coronary artery bypass surgery. These results suggested that pretreatment with trimetazidine and GIK infusion protocol do not significantly reduce ischemic reperfusion damage.
NaturalLanguageKeyword :
Trimetazidine , glucose , insulin , potassium , myocardial protection , off , pump coronary artery bypass
