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

Détails

Ressource 1Télécharger: serval:BIB_F66FB0D15106.P001 (110.63 [Ko])
Etat: Public
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ID Serval
serval:BIB_F66FB0D15106
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Preconditioning with sevoflurane decreases PECAM-1 expression and improves one-year cardiovascular outcome in coronary artery bypass graft surgery
Périodique
British Journal of Anaesthesia
Auteur(s)
Garcia  C., Julier  K., Bestmann  L., Zollinger  A., von Segesser  L.K., Pasch  T., Spahn  D.R., Zaugg  M.
ISSN
0007-0912
Statut éditorial
Publié
Date de publication
02/2005
Peer-reviewed
Oui
Volume
94
Numéro
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
Résumé
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.
Mots-clé
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
Oui
Création de la notice
14/02/2008 15:17
Dernière modification de la notice
01/10/2019 7:20
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