Effects of N-acetylcysteine on myocardial ischemia-reperfusion injury in bypass surgery
Heart and Vessels, vol.21, no.1, pp.42-47, 2006 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 21 Issue: 1
- Publication Date: 2006
- Doi Number: 10.1007/s00380-005-0873-1
- Journal Name: Heart and Vessels
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.42-47
- Keywords: Cardiovascular surgery, Endothelial function, Free fradicals, N-Acetylcysteine, Reperfusion, Tumor necrosis factor-α
- Istanbul Kent University Affiliated: No
Abstract
Myocardial ischemia-reperfusion injury may complicate coronary artery bypass grafting (CABG) operations. N-Acertylcysteine (NAC) had antioxidant and microcirculatory effects, and inhibits neutrophil aggregation. The aim of this study was to determine the effects of NAC in limiting myocardial ischemia-reperfusion injury in CABG operations. Twenty patients undergoing elective coronary bypass operation with cardiopulmonary bypass were enrolled and randomly assigned to two groups: a control group operated with a routine CABG protocol, and one where NAC was administered intravenously during the operation (NAC group). Blood samples from coronary sinus for tumor necrosis factor-α assay, myocardial biopsy specimens for chemiluminescent luminol, and lucigenin measurements of reactive oxygen species were taken. The luminol (specific for •OH, H2 O2, and HOCl- radicals) and lucigenin (specific for O2•-) levels and the difference ratios after reperfusion were significantly lower in the NAC group. Tumor necrosis factor-α levels increased in the control group but, in contrast, a significant decrease was detected in the NAC group (P < 0.01). Creatine kinase-MB levels at 6 and 12 hours were singnificantly lower in the NAC group (P = 0.02). N-Acetylcysteine has potential effects to limit ischemia reperfusion injury during CABG operations. We believe that its effects on clinical outcome may be more apparent in patients prone to ischemia-reperfusion injury. © Springer-Verlag 2006.