HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Ismail Koramaz Zerrin Pulathan Fahri Ozcan Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Koramaz, I. Articles by Ozcan, F. Search for Related Content PubMed PubMed Citation Articles by Koramaz, I. Articles by Ozcan, F. Related Collections Myocardial protection

Ann Thorac Surg 2006;81:613-618
© 2006 The Society of Thoracic Surgeons

---

Original article: Cardiovascular

Cardioprotective Effect of Cold-Blood Cardioplegia Enriched with N-Acetylcysteine During Coronary Artery Bypass Grafting

^a Department of Cardiovascular Surgery, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
^b Department of Biochemistry, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
^c Department of Pharmacology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey

Accepted for publication August 15, 2005.

^_* Address correspondence to Dr Koramaz, Karadeniz Technical University, School of Medicine, Department of Cardiovascular Surgery, TR-61187 Trabzon, Turkey (Email: ismailkoramaz{at}yahoo.com).

BACKGROUND: Cold-blood cardioplegia is a well-known method in coronary artery bypass graft surgery, and several authors have used various agents in the enrichment of cold-blood cardioplegia to decrease ischemia–reperfusion injury seen during surgery. N-acetylcysteine, which can increase glutathione levels, is one of the agents added to cardioplegic solutions to decrease myocardial injury. This study was planned to assess the efficiency of N-acetylcysteine–enriched cold-blood cardioplegia on early reperfusion injury in patients with ischemic heart disease undergoing coronary artery bypass grafting, using measurements of cardiac troponin I and malondialdehyde release.

METHODS: Thirty patients (11 women and 19 men) with left ventricular ejection fraction greater than 0.40 scheduled for coronary artery bypass grafting were randomly divided into two groups. We used cold-blood cardioplegia enriched with N-acetylcysteine (50 mg per kilogram of body weight) in the first group and cold-blood cardioplegia alone in the second group. Hemodynamic variables and clinical properties of the patients were preoperatively and postoperatively evaluated. Enzyme releases were measured in the early hours after the operation.

RESULTS: In the N-acetylcysteine–enriched group cardiac troponin I levels were lower than in the N-acetylcysteine–free group, and this difference was statistically significant. Cardiac troponin I levels increased in both groups in the 6th and 12th hours postoperatively, but there was a statistically significant difference between the two groups. Malondialdehyde levels were significantly higher in the N-acetylcysteine–free group after the 6th, 12th, 24th, and 48th hours postoperatively when compared with the N-acetylcysteine–enriched group.

CONCLUSIONS: N-acetylcysteine–supplemented cold-blood cardioplegia minimizes myocardial injury in the early hours after and during the cardiac surgery.

This article has been cited by other articles:

				J. Zhu, R. Yin, H. Shao, G. Dong, L. Luo, and H. Jing N-acetylcysteine to ameliorate acute renal injury in a rat cardiopulmonary bypass model J. Thorac. Cardiovasc. Surg., March 1, 2007; 133(3): 696 - 703. [Abstract] [Full Text] [PDF]