Early changes in plasma antioxidant and lipid peroxidation levels following coronary artery bypass surgery: a complex response

Hadjinikolaou, Leon; Alexiou, Christos; Cohen, Andrew S.; Standbridge, Rex De L; McColl, Averil J; Richmond, W.

doi:10.1016/s1010-7940(03)00115-5

Cited by 20 publications

(19 citation statements)

References 22 publications

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“…Increased venous concentration of malonyldialdehyde has been found in patients subjected to cardiac surgery [10,11,44]. However, malonyldialdehyde concentrations in systemic blood may reflect changes unrelated to cardiac oxidative stress (prostanoid synthesis [45], activity of aldehyde-dehydrogenase [35] and aldosereductase [36]).…”

Section: Discussionmentioning

confidence: 99%

“…However, malonyldialdehyde concentrations in systemic blood may reflect changes unrelated to cardiac oxidative stress (prostanoid synthesis [45], activity of aldehyde-dehydrogenase [35] and aldosereductase [36]). Indeed, surgery itself (independent of cardioplegic arrest/reperfusion) may induce systemic lipid peroxidation [18,44,46]. To specifically investigate lipid peroxidation at cardiac level, we simultaneously measured lipid peroxides in the blood entering the heart and in the coronary sinus effluent, and therefore could establish that no cardiac release of lipid peroxides occurred.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between oxidative stress, lipid peroxidation, and ultrastructural damage in patients with coronary artery disease undergoing cardioplegic arrest/reperfusion

Milei¹,

Forcada²,

Fraga

et al. 2007

Cardiovasc Res

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Relationship between oxidative stress, lipid peroxidation, and ultrastructural damage in patients with coronary artery disease undergoing cardioplegic arrest/reperfusion

Milei¹,

Forcada²,

Fraga

et al. 2007

Cardiovasc Res

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show abstract

“…4,5,22 Oxidative stress results from an imbalance between local antioxidant defences and formation of reactive oxygen derived free radicals, which are generated and released by activated inflammatory cells. ROS are highly reactive and can induce lipid peroxidation (oxidation of membrane phospholipids) and the accumulation of their products including MDA, 7,16,23,24 4-hydroxy-2-nonenal, acrolein, hydroperoxides 6 and F2-isoprostanes 7,10,14 acts as an indirect measure of free radical activity. 8,9,25 Experiments have demonstrated that oxidative stress may cause alterations in essential components of the lung, contributing to pathological abnormalities and functional changes.…”

Section: Discussionmentioning

confidence: 99%

Effect of N - Acetylcysteine on Oxidative Stress in Patients Undergoing Off Pump Coronary Artery Bypass Grafting

Jalakandan¹,

Bhaskaran²,

Hiremath³

2015

jemds

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OBJECTIVE: Increasingly used Off Pump Coronary Artery Bypass Grafting (OPCABG) has significantly reduced the oxidative stress and decreased the inflammatory response associated with the use of Cardiopulmonary by Pass (CPB). However, OPCABG is associated with significant oxidative stress and its associated complications. This present study is a prospective, randomized, double blind investigating the effects of N-acetylcysteine (NAC), a potent anti-oxidant on oxidative stress in patients undergoing OPCABG. METHODS: Fifty patients undergoing elective OPCABG were randomized into two groups. Group A (n=25), the control group received 200ml of Normal saline immediately following induction, whereas Group B (n=25), the study group received 150mg/kg of NAC in 200ml of Normal saline at the corresponding time. At the end of surgery, all the patients were shifted to intensive care unit (ICU) and were extubated at the earliest possible time. Malondialdehyde (MDA), a marker of free radical injury and Glutathione (GSH) Levels were assayed from the 2 blood samples obtained (First sample immediately following induction and the second immediately after shifting to ICU). RESULTS: Demographic profile, pre-incision clinical and biochemical values were comparable in both the groups. At the end of surgery, MDA levels were significantly raised in control group (p<0.001) whereas its levels were maintained in study group (p<0.569). GSH levels were significantly decreased in control group (p<0.001) whereas its levels were significantly increased in study group (p<0.001). CONCLUSION: These results revealed that OPCABG was associated with significant oxidative response and the administration of N-Acetylcysteine attenuates this stress response by replenishing the Glutathione stores.

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“…5,6 To counterbalance this sequence of events and diminish oxidative injury, several studies have investigated and recommended the use of antioxidant supplements. 18 To prevent elevations in proinflammatory cytokines and complement activation during cardiac surgery, several agents viz.…”

Section: Discussionmentioning

confidence: 99%

Effect of N - Acetylcysteine on Pulmonary Function in Patients Undergoing Off Pump Coronary Artery Bypass Grafting

Jalakandan¹,

Bhaskaran²

2015

jemds

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OBJECTIVE:Postoperative lung injury is one of the most frequent complications of cardiac surgery. Increasingly used Off Pump Coronary Artery Bypass Grafting (OPCABG) has significantly reduced the oxidative stress and the inflammatory response associated with the use of cardiopulmonary bypass (CPB). However, OPCABG is also associated with significant oxidative stress and its related complications. The present study is a prospective, randomized, double blind investigating the effects of N-acetylcysteine (NAC), a potent anti-oxidant on pulmonary functions in patients undergoing OPCABG. METHODS: Fifty patients undergoing elective OPCABG were randomized into two groups. Group A (n=25), the control group received 200ml of Normal saline immediately following induction whereas Group B (n=25), the study group received 150mg/kg of NAC in 200ml of Normal saline at the same time. Pulmonary Capillary Wedge Pressure (PCWP), Pulmonary Artery Pressure (PAP), Dynamic lung compliance (C Dyn), Static lung compliance (C Stat), Alveolar -arterial oxygen gradient (A-a Do2) were measured immediately following induction, after admission into ICU, and then 4 th hourly till extubation. Malondialdehyde (MDA) and Glutathione (GSH) levels were assayed once immediately following induction and again immediately after shifting to ICU. RESULTS: Demographic profile, pre-incision clinical and biochemical values were comparable in both the groups. PCWP, PAP-Diastole were lower and C Dyn and C Stat were significantly higher in study group when compared to control group. No difference in PAP-Systole was found. Both the groups had increased A-a Do2, but the increase was significantly lower in the study group. At the end of surgery, MDA levels were significantly raised in control group (p<0.001) whereas its levels were maintained in study group (p<0.569). GSH levels were significantly decreased in control group (p<0.001) whereas its levels were significantly increased in study group (p<0.001). CONCLUSION: OPCABG was associated with significant oxidative response but the administration of NAC attenuates this stress response by replenishing the GSH stores. NAC improves pulmonary function in terms of increased compliance and increased systemic oxygenation.

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Early changes in plasma antioxidant and lipid peroxidation levels following coronary artery bypass surgery: a complex response

Abstract: TPAC is suppressed for 72 h following CABG. TPAC depression may be involved in the mechanism of lipid peroxidation and is influenced by clinical factors known to be related to post CABG morbidity and mortality, like low ejection fraction and long ischaemic times.

Cited by 20 publications

References 22 publications

Relationship between oxidative stress, lipid peroxidation, and ultrastructural damage in patients with coronary artery disease undergoing cardioplegic arrest/reperfusion

Relationship between oxidative stress, lipid peroxidation, and ultrastructural damage in patients with coronary artery disease undergoing cardioplegic arrest/reperfusion

Effect of N - Acetylcysteine on Oxidative Stress in Patients Undergoing Off Pump Coronary Artery Bypass Grafting

Effect of N - Acetylcysteine on Pulmonary Function in Patients Undergoing Off Pump Coronary Artery Bypass Grafting

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