Nitecapone as an additive to crystalloid cardioplegia in patients who had coronary artery bypass grafting.
BACKGROUND
Nitecapone has been shown to have a protective effect against ischemia-reperfusion injury in experimental heart transplantation and in Langendorff preparations. This prospective, randomized study assessed the effects of nitecapone in patients who had coronary artery bypass grafting.


METHODS
Thirty patients with normal myocardial function were randomly divided into control patients (n = 15), who received crystalloid (Plegisol) cardioplegia, and nitecapone patients, who received nitecapone in a 50 microM solution (n = 15) in Plegisol. Cardioplegia was administered as an initial dose of 15 mL/kg of body mass after cross-clamping and 2 mL/kg every 15 minutes. Simultaneous coronary sinus and aortic blood samples, and myocardial biopsies were taken at 1, 5, and 10 minutes after unclamping. Hemodynamics were measured invasively for 24 hours and with transesophageal echocardiography for 3 hours after cardiopulmonary bypass.


RESULTS
There were no adverse effects. The incidence of ventricular arrhythmias was significantly lower in the treatment group during the recovery period (p = 0.02). Cardiac output and stroke volume did not differ significantly between the groups. The conjugated dienes gradient between the aorta and the coronary sinus increased significantly during the first minute of reperfusion in the control group (p = 0.02) compared with the nitecapone group. Myeloperoxidase activity in myocardial biopsies was higher in the control group (2.3 times higher at 5 minutes and 3.2 times higher at 10 minutes) than in the nitecapone group (p = 0.13).


CONCLUSIONS
Nitecapone did not exert any significant hemodynamic effects in patients with normal ejection fraction.
Vento
A E
AE
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland.
Aittomäki
J
J
Verkkala
K A
KA
Heikkilä
L J
LJ
Salo
J A
JA
Sipponen
J
J
Rämö
O J
OJ
D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage* / Q000009:adverse effects; D002314:Cardioplegic Solutions; D002396:Catechols / Q000008:administration & dosage* / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000379:methods*; D003326:Coronary Circulation / Q000187:drug effects; D004734:Energy Metabolism / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D015227:Lipid Peroxidation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010422:Pentanones / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies
D000975:Antioxidants; D002314:Cardioplegic Solutions; D002396:Catechols; D010422:Pentanones; C057364:nitecapone