Cardioprotective effect of adenosine pretreatment in coronary artery bypass grafting.
OBJECTIVE
There are several reports of the use of adenosine as a cardioprotective agent during cardiac surgery. Adenosine treatment might affect neutrophils and inflammatory mediators. The present prospective randomized study was designed to investigate the effect of adenosine pretreatment on myocardial recovery and inflammatory response in patients undergoing elective coronary artery bypass surgery.


METHODS
A prospective, randomized, controlled study.


METHODS
Operative unit and ICU in a university hospital in Finland.


METHODS
Thirty male patients undergoing primary, elective coronary revascularization.


METHODS
Patients in the adenosine group received a 7-min infusion of adenosine (total, 650 microg/kg) before the initiation of cardiopulmonary bypass.


METHODS
Postoperative creatine kinase (CK)-MB release and hemodynamics were recorded. Perioperative leukocyte and cytokine release were measured.


RESULTS
Adenosine pretreatment resulted in less CK-MB release and an improved postbypass cardiac index. Similar leukocyte counts and cytokine responses were seen in both groups perioperatively. Neutrophil counts were similar between the groups before and after myocardial ischemia when measured simultaneously in arterial and coronary sinus blood.


CONCLUSIONS
The present results support the hypothesis that adenosine pretreatment is cardioprotective in humans, but the present dose failed to regulate the inflammatory responses after coronary artery bypass grafting.
Wei
M
M
Division of Cardiovascular Surgery, Tampere University Hospital, Tampere, Finland.
Kuukasjärvi
P
P
Laurikka
J
J
Honkonen
E L
EL
Kaukinen
S
S
Laine
S
S
Tarkka
M
M
D000241:Adenosine / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D016207:Cytokines / Q000032:analysis; D006321:Heart / Q000187:drug effects*; D006439:Hemodynamics; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies
D002317:Cardiovascular Agents; D016207:Cytokines; D000241:Adenosine