The effects of intracoronary administration of vitamin E on myocardial ischemia-reperfusion injury during coronary artery surgery.
BACKGROUND
Vitamin E has a strong antioxidant capacity, and has been used in several ischemia-reperfusion studies. The aim of this study was to investigate the effects of water-soluble vitamin E (alpha-tocopherol) on myocardial protection during coronary artery surgery.


METHODS
Water soluble vitamin E (100 mg) in tepid saline (n = 14) or tepid saline alone (n = 16) was administered into the coronary arteries at the end of aortic cross-clamping. Cardiac troponin-I (cTn-I), MB-isoenzyme of creatine kinase (CK-MB), myoglobin, blood gas, and lactate levels in systemic and coronary sinus blood and hemodynamic variables were assessed during and after the operation.


RESULTS
Eight hours after reperfusion, cTn-I levels increased to 3.06 +/- 1.8 ng/ml and 6.97 +/- 3.9 ng/ml in the vitamin E group and control group, respectively (p = 0.01). Coronary sinus lactate concentration was 2.68 +/- 0.5 mmol/l in the vitamin E group and 4.01 +/- 1.5 mmol/l in the control group 60 minutes after reperfusion (p = 0.027).


CONCLUSIONS
Administration of vitamin E into the coronary arteries before removal of the aortic cross-clamp can reduce myocardial cell injury and protect the myocardium from ischemia-reperfusion injury.
Trakya University, Medical Faculty, Department of Cardiovascular Surgery, Edirne, Turkey. scanbaz2001@yahoo.com
S
S
Canbaz
E
E
Duran
T
T
Ege
H
H
Sunar
M
M
Cikirikcioglu
M
M
Acipayam
D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001784:Blood Gas Analysis; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood / Q000187:drug effects; D052279:Creatine Kinase, MB Form; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007269:Injections, Intra-Arterial; D007431:Intraoperative Complications / Q000097:blood / Q000188:drug therapy*; D007527:Isoenzymes / Q000097:blood / Q000187:drug effects; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000097:blood / Q000188:drug therapy*; D009211:Myoglobin / Q000097:blood / Q000187:drug effects; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood / Q000187:drug effects; D014810:Vitamin E / Q000008:administration & dosage / Q000627:therapeutic use*
D000975:Antioxidants; D015415:Biomarkers; D007527:Isoenzymes; D009211:Myoglobin; D019210:Troponin I; D014810:Vitamin E; D019344:Lactic Acid; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form; D010100:Oxygen