Effect of Ischemic Preconditioning on Myocardial Protection in Coronary Artery Bypass Graft Patients

Interaction of Risk Factors, Comorbidities, and Comedications with Ischemia/Reperfusion Injury and Cardioprotection by Preconditioning, Postconditioning, and Remote Conditioning

“…There are also a number of studies where an ischemic preconditioning algorithm was used in coronary artery bypass graft or valvular surgery, and protection was seen in terms of reduced release of serum biomarkers (creatine kinase-MB, troponin I or T) (Jenkins et al, 1997;Lu et al, 1997;Szmagala et al, 1998;Li et al, 1999;Teoh et al, 2002a,b;Buyukates et al, 2005;Codispoti et al, 2006;Ji et al, 2007;Amr and Yassin, 2010). However, not all studies were positive (Alkhulaifi et al, 1994;Perrault et al, 1996;Cremer et al, 1997;Kaukoranta et al, 1997;Illes and Swoyer, 1998;Pêgo-Fernandes et al, 2000;Wu et al, 2001;Ghosh and Galinanes, 2003;Jebeli et al, 2010). Both positive and Confounders of Cardioprotection negative studies suffer from small cohort sizes and lack of clinical outcome as endpoint.…”

Ischemic Preconditioning in Cardiac Surgery

“…But the weaning protective effects after 2 days may be recovered by another IP stimuli [39, 51,52]. The protective IP effects IP effects do not include suppressing lactate production and FR generation during the early reperfusion period [53,54]. The IP protocol induces lactate production but seems not to be involved in the triggering process [54].…”

“…The IP protocol induces lactate production but seems not to be involved in the triggering process [54]. The low concentration of FR after the IP protocol was associated with better hemodynamic recovery in CABG patients, suggesting that FR might act as one of the triggers for IP [53]. Since preservation of RV integrity during cardiac surgery is more difficult than LV protection.…”

“…There was evidence of preconditioning in cultures of human cardiomyocytes [17], human myocardial tissue [18][19][20][21][22][23] and clinical patients [24][25][26][27][28][29][30][31][32]. This myocardial protective effect was also studied in clinical interventions including coronary angioplasty [33][34][35][36][37][38] and cardiac surgery [39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55].…”

“…IP has been proved to be a potent endogenous factor in delaying myocardial infarction [1,3,24,26,27,32], suppressing arrhythmias induced by ischemia and reperfusion [3,5,37,38,[56][57][58][59][60], preserving high-energy phosphate [1,43,44], improving postischemic functional recovery [7][8][9][46][47][48][51][52][53][54][55], attenuating myocardial cellular apoptosis [61,62], delaying myocardial ultrastructure damage [10], attenuating intracellular acidosis, reducing anaerobic glycolytic end-product lactate [11,63,64], reducing the utilization of myocardial glycogen [44] and protecting the coronary endothelium [65]. Report of preconditioning phenomenon was dated to half a century ago when Noble described stress adapted animals had resistance to severe trauma [66].…”