Preconditioning with sevoflurane decreases PECAM-1 expression and improves one-year cardiovascular outcome in coronary artery bypass graft surgery

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Serval ID
serval:BIB_F66FB0D15106
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Preconditioning with sevoflurane decreases PECAM-1 expression and improves one-year cardiovascular outcome in coronary artery bypass graft surgery
Journal
British Journal of Anaesthesia
Author(s)
Garcia  C., Julier  K., Bestmann  L., Zollinger  A., von Segesser  L.K., Pasch  T., Spahn  D.R., Zaugg  M.
ISSN
0007-0912
Publication state
Published
Issued date
02/2005
Peer-reviewed
Oui
Volume
94
Number
2
Pages
159-65
Notes
Clinical Trial Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't --- Old month value: Feb
Abstract
BACKGROUND: Cardiac preconditioning is thought to be involved in the observed decreased coronary artery reocclusion rate in patients with angina preceding myocardial infarction. We prospectively examined whether preconditioning by sevoflurane would decrease late cardiac events in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: Seventy-two patients scheduled for elective CABG surgery were randomized to preconditioning by sevoflurane (10 min at 4 vol%) or placebo. For all patients, follow-up of adverse cardiac events was obtained 6 and 12 months after surgery. Transcript levels for platelet-endothelial cell adhesion molecule-1 (PECAM-1/CD31), catalase and heat shock protein 70 (Hsp70) were determined in atrial biopsies after sevoflurane preconditioning. RESULTS: Pharmacological preconditioning by sevoflurane reduced the incidence of late cardiac events during the first year after CABG surgery (sevoflurane 3% vs 17% in the placebo group, log-rank test, P=0.038). One patient in the sevoflurane group and three patients in the placebo group experienced new episodes of congestive heart failure and three additional patients had coronary artery reocclusion. Perioperative peak concentrations for myocardial injury markers were higher in patients with subsequent late cardiac events [NTproBNP, 9031 (4125) vs 3049 (1906) ng litre(-1), P<0.001; cTnT, 1.31 (0.88) vs 0.46 (0.29) microg litre(-1), P<0.001]. Transcript levels were reduced for PECAM-1 and increased for catalase but unchanged for Hsp70 in atrial biopsies after sevoflurane preconditioning. CONCLUSIONS: This prospective randomized clinical study provides evidence of a protective role for pharmacological preconditioning by sevoflurane in late cardiac events in CABG patients, which may be related to favourable transcriptional changes in pro- and antiprotective proteins.
Keywords
Adult Aged Aged, 80 and over Anesthetics, Inhalation/*therapeutic use Antigens, CD31/*blood Cardiotonic Agents/therapeutic use *Coronary Artery Bypass Disease-Free Survival Female Heart Diseases/prevention & control Humans Ischemic Preconditioning, Myocardial/*methods Male Methyl Ethers/*therapeutic use Middle Aged Postoperative Complications/prevention & control Prospective Studies Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
14/02/2008 15:17
Last modification date
01/10/2019 7:20
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