Cardioprotection by nifedipine cardioplegia during coronary artery surgery.
In a double-blind, placebo-controlled, randomized clinical study, the cardioprotective effect of nifedipine (Adalat, Bayer) as an adjunct to St. Thomas' cardioplegia was investigated in 24 patients undergoing coronary artery bypass grafting. Nifedipine at a dosage of 200 micrograms or placebo was added to each 1000 ml of St. Thomas solution, under strict light protection. ECG and haemodynamic data, including cardiac output measurements, serum calcium levels, creatine phosphokinase, (CK) CK-MB and lactate were measured during and after the operation. Additional cardioprotective effects were demonstrated in the nifedipine group by a significantly lesser reduction of the cardiac index after cardiopulmonary bypass and lower post-operative CK and CK-MB serum levels (P < 0.05). The incidence of ischaemia and cardiac arrhythmias was significantly higher in the placebo group on the post-operative ECG.
Trubel
W
W
2nd Department of Surgery, University of Vienna, Austria.
Zwoelfer
W
W
Moritz
A
A
Laczkovics
A
A
Haider
W
W
D001145:Arrhythmias, Cardiac / Q000209:etiology; D001639:Bicarbonates / Q000008:administration & dosage; D002122:Calcium Chloride / Q000008:administration & dosage; D002302:Cardiac Output / Q000187:drug effects; D002303:Cardiac Output, Low / Q000209:etiology; D002314:Cardioplegic Solutions / Q000008:administration & dosage; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006321:Heart / Q000187:drug effects*; D006324:Heart Arrest, Induced; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007527:Isoenzymes; D008274:Magnesium / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology; D009543:Nifedipine / Q000008:administration & dosage / Q000627:therapeutic use*; D010919:Placebos; D011189:Potassium Chloride / Q000008:administration & dosage; D012965:Sodium Chloride / Q000008:administration & dosage
D001639:Bicarbonates; D002314:Cardioplegic Solutions; D007527:Isoenzymes; D010919:Placebos; C041711:St. Thomas' Hospital cardioplegic solution; D012965:Sodium Chloride; D011189:Potassium Chloride; D003402:Creatine Kinase; D008274:Magnesium; D009543:Nifedipine; D002122:Calcium Chloride