Pretreatment with Methylprednisolone Improves Myocardial Protection during On-Pump Coronary Artery Bypass Surgery

Authors

  • Tolga Demir Department of Cardiovascular Surgery, Kolan International Hospital, Istanbul
  • Mehmet Umit Ergenoglu Department of Cardiovascular Surgery, Kolan International Hospital, Istanbul
  • Hale Bolgi Demir Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul
  • Nursen Tanrikulu Department of Anesthesiology, Kolan International Hospital, Istanbul
  • Mazlum Sahin Department of Cardiovascular Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul
  • Emre Gok Department of Cardiovascular Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul
  • Kubilay Korkut Department of Cardiovascular Surgery, Kolan International Hospital, Istanbul
  • Ergun Demirsoy Department of Cardiovascular Surgery, Kolan International Hospital, Istanbul

DOI:

https://doi.org/10.1532/hsf.1367

Abstract

Background: This study was undertaken to determine whether methylprednisolone could improve myocardial protection by altering the cytokine profile toward an anti-inflammatory course in patients undergoing elective coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB).
Methods: Forty patients who were scheduled for elective CABG surgery were randomized into two groups: the study group (n = 20), who received 1 g of methylprednisolone intravenously before CPB, and the control group (n = 20), who underwent a standard CABG surgery without any additional medication. Blood samples were withdrawn prior to surgery (T1) and then 4 hours (T2), 24 hours (T3), and 36 hours (T4) after CPB. Plasma levels of interleukin (IL)-6, IL-10, creatine kinase isoenzyme MB (CK-MB), cardiac troponin-t (cTnT), and blood glucose as well as neutrophil counts were measured at each sampling time.
Results: A comparison of patients between both groups revealed significantly high levels of IL-6 in the control group at T2, T3, and T4 with respect to T1 (T2: P < .001; T3:
P < .001; T4: P < .001). IL-10 levels were significantly higher in the study group at T2 compared with the control group
(P = .007). CK-MB levels were significantly lower in the study group than in the control group at T4 (P = .001). The increase of cTnT was higher in the control group at T3 and T4 compared with the study group (T3: P = .002; T4: P = .001).
Conclusions: This study demonstrates that methylprednisolone is effective for ensuring better myocardial protection during cardiac surgery by suppressing the inflammatory response via decreasing the levels of IL-6 and by increasing anti-inflammatory activity through IL-10.

Published

2015-08-30

How to Cite

Demir, T., Ergenoglu, M. U., Demir, H. B., Tanrikulu, N., Sahin, M., Gok, E., Korkut, K., & Demirsoy, E. (2015). Pretreatment with Methylprednisolone Improves Myocardial Protection during On-Pump Coronary Artery Bypass Surgery. The Heart Surgery Forum, 18(4), E171-E177. https://doi.org/10.1532/hsf.1367

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