title: Aprotinin decreases ischemic damage during coronary revascularization.
abstract: OBJECTIVE
  This study sought to determine whether the favorable anti-inflammatory effects of aprotinin might limit ischemic damage during the revascularization of ischemic myocardium.
  
  
  METHODS
  Twenty pigs underwent 90 minutes of coronary occlusion followed by 45 minutes of blood cardioplegic arrest and 180 minutes of reperfusion. Ten animals received a loading dose of aprotinin (40,000 kallikrein inhibiting units/kg) during the start of coronary occlusion followed by an infusion of 20,000 kallikrein inhibiting units/kg/hour. Ten other animals received no aprotinin. Summary statistics are expressed as the mean +/- standard error.
  
  
  RESULTS
  The aprotinin-treated animals required less cardioversions for ventricular arrhythmias (1.0 +/- 0.7 vs. 3.6 +/- 0.6; p < 0.001), accumulated less lung water (1.0 +/- 0.2% change vs. 6.2 +/- 0.9% change; p = 0.038), had more complete coronary relaxation to bradykinin (34.1 +/- 5.9% change vs. 9.2 +/- 3.5% change; p = 0.01), and had reduced infarct size (area necrosis/area risk = 20 +/- 1.1% vs. 39 +/- 1.2%; p = 0.003).
  
  
  CONCLUSIONS
  Aprotinin limits ischemic injury during acute coronary revascularization by decreasing ventricular arrhythmias and lung edema, preserving endothelial function, and minimizing myocardial necrosis.
authors.affiliation: Department of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts 02118, USA. harold.lazar@bmc.org.
authors.forename: Harold L
authors.initials: HL
authors.lastname: Lazar
authors.forename: Yusheng
authors.initials: Y
authors.lastname: Bao
authors.forename: Leslie
authors.initials: L
authors.lastname: Tanzillo
authors.forename: Paul
authors.initials: P
authors.lastname: O'Gara
authors.forename: Deborah
authors.initials: D
authors.lastname: Reardon
authors.forename: David
authors.initials: D
authors.lastname: Price
authors.forename: Richard
authors.initials: R
authors.lastname: Crowley
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Cabral
mesh_terms: D000818:Animals; D007611:Aprotinin / Q000494:pharmacology* / Q000627:therapeutic use; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004195:Disease Models, Animal; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D015633:Extravascular Lung Water / Q000187:drug effects; D017682:Myocardial Stunning / Q000209:etiology / Q000517:prevention & control*; D015842:Serine Proteinase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D013552:Swine; D014664:Vasodilation / Q000187:drug effects
chemical_list: D015842:Serine Proteinase Inhibitors; D007611:Aprotinin