Effects of inorganic nitrate on ischaemia-reperfusion injury after coronary artery bypass surgery: a randomised controlled trial
| Autor: | Karin E. Eriksson, Anders Franco-Cereceda, Eddie Weitzberg, Jan Liska, Fredrik Eidhagen, Jon O. Lundberg |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Blood Loss Surgical Myocardial Reperfusion Injury Nitric Oxide Cardiovascular Placebo law.invention Nitric oxide chemistry.chemical_compound Coronary artery bypass surgery Double-Blind Method Troponin T ischaemia-reperfusion injury nitrate law Preoperative Care Cardiopulmonary bypass medicine Clinical endpoint Humans Coronary Artery Bypass perioperative nitrite Aged Cardiopulmonary Bypass Nitrates business.industry Perioperative Middle Aged bleeding Cardiac surgery Anesthesiology and Pain Medicine chemistry Anesthesia Female business Biomarkers cardiac surgery |
| Zdroj: | BJA: British Journal of Anaesthesia |
| ISSN: | 0007-0912 |
| Popis: | Background Nitric oxide (NO) is an important signalling molecule in the cardiovascular system with protective properties in ischaemia–reperfusion injury. Inorganic nitrate, an oxidation product of endogenous NO production and a constituent in our diet, can be recycled back to bioactive NO. We investigated if preoperative administration of inorganic nitrate could reduce troponin T release and other plasma markers of injury to the heart, liver, kidney, and brain in patients undergoing cardiac surgery. Methods This single-centre, randomised, double-blind, placebo-controlled trial included 82 patients undergoing coronary artery bypass surgery with cardiopulmonary bypass. Oral sodium nitrate (700 mg×2) or placebo (NaCl) were administered before surgery. Biomarkers of ischaemia–reperfusion injury and plasma nitrate and nitrite were collected before and up to 72 h after surgery. Troponin T release was our predefined primary endpoint and biomarkers of renal, liver, and brain injury were secondary endpoints. Results Plasma concentrations of nitrate and nitrite were elevated in nitrate-treated patients compared with placebo. The 72-h release of troponin T did not differ between groups. Other plasma biomarkers of organ injury were also similar between groups. Blood loss was not a predefined outcome parameter, but perioperative bleeding was 18% less in nitrate-treated patients compared with controls. Conclusion Preoperative administration of inorganic nitrate did not influence troponin T release or other plasma biomarkers of organ injury in cardiac surgery. Clinical trial registration NCT01348971. |
| Databáze: | OpenAIRE |
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