Does diltiazem inhibit the inflammatory response in cardiopulmonary bypass?
BACKGROUND
The objective of our study was to investigate the anti-inflammatory effect and inhibiting action of diltiazem, a calcium channel blocking agent, on the systemic inflammatory response seen after cardiopulmonary bypass (CPB) in humans, in a controlled prospective study.


METHODS
Two groups of 15 candidates for coronary artery bypass graft were enrolled in the study. In the study group, 1  g/kg/min of diltiazem was infused during cardiopulmonary bypass, while the control group received saline. Interleukin-6 and 10 (IL-6, IL-10) levels were measured from systemic arterial blood at five time points.


RESULTS
The levels of IL-6, a marker of the severity of systemic inflammation, were significantly higher in the control group at the end of CPB and 3 hours later. At the end of CPB, the mean IL-6 level in the control group was significantly higher than in the diltiazem group (p=0.015), and at 3 hours after CPB the difference was even greater (p=0.002). The levels of IL-10, an anti-inflammatory cytokine that limits the effects of pro-inflammatory cytokines, were higher in the control group, but not statistically significant at any time point.


CONCLUSIONS
Diltiazem inhibits the release of the pro-inflammatory cytokine IL-6, which is strong evidence for its anti-inflammatory effect. It is clinically important to inhibit the inflammation that takes place during CPB and the inflammation of myocardium encountered after ischemia-reperfusion, since these effect the clinical status of the patient after CPB, as well as myocardial functions.
Fansa
Iyad
I
T rkiye Y ksek Ihtisas Hospital, Cardiovascular Surgery Clinic, Sihhiye, Ankara, Turkey.
Gol
Mehmet
M
Nisanoglu
Vedat
V
Yavas
Soner
S
Iscan
Zafer
Z
Tasdemir
Oguz
O
D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood; D001792:Blood Platelets / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D004110:Diltiazem / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007902:Length of Stay; D007962:Leukocytes / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
D002121:Calcium Channel Blockers; D015850:Interleukin-6; D016753:Interleukin-10; D001219:Aspartate Aminotransferases; D004110:Diltiazem