title: Effect of ascorbic acid on inflammatory markers after cardiothoracic surgery.
abstract: OBJECTIVE
  The effect of ascorbic acid on inflammatory markers after cardiothoracic surgery (CTS) was studied.
  
  
  METHODS
  In this randomized, double-blind, placebo-controlled trial, patients undergoing cardiopulmonary bypass graft surgery or valve replacement surgery from April 2009 through March 2010 at Hartford Hospital were randomized to receive ascorbic acid (2-g loading dose followed by 500 mg every 12 hours) or matching placebo the evening before surgery and for four days postoperatively. Inflammatory mediators were measured preoperatively and on postoperative days 1-4. Intergroup comparisons were performed using two-tailed t tests and Fisher's exact test. Multiple comparisons were conducted using repeated analyses of variance with Bonferroni tests.
  
  
  RESULTS
  Of the 62 patients screened, 24 met the study inclusion criteria. Of these, 13 were assigned to receive ascorbic acid and 11 received placebo. Ascorbic acid did not affect the natural course of inflammatory marker rise for C-reactive protein (CRP) concentration, white blood cell (WBC) count, or fibrinogen concentration versus placebo at any evaluated time point (p > 0.05 for all intergroup comparisons). Intragroup analyses demonstrated significant differences among baseline and postoperative measures of all inflammatory mediators (p < 0.05). No significant differences were noted in inflammatory markers between patients undergoing cardiothoracic surgery with or without cardiopulmonary bypass, regardless of treatment group.
  
  
  CONCLUSIONS
  Ascorbic acid did not attenuate the rise in inflammatory markers after CTS when compared with placebo. The use of off-pump surgery did not significantly change the levels of CRP and fibrinogen or the WBC count postoperatively when compared with on-pump surgery with a biocompatible polymer coating.
authors.affiliation: Hartford Hospital, CT 06102, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Colby
authors.forename: Wendy T
authors.initials: WT
authors.lastname: Chen
authors.forename: William L
authors.initials: WL
authors.lastname: Baker
authors.forename: Craig I
authors.initials: CI
authors.lastname: Coleman
authors.forename: Kurt
authors.initials: K
authors.lastname: Reinhart
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kluger
authors.forename: C Michael
authors.initials: CM
authors.lastname: White
mesh_terms: D000368:Aged; D001205:Ascorbic Acid / Q000494:pharmacology*; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D014815:Vitamins / Q000494:pharmacology
chemical_list: D015415:Biomarkers; D014815:Vitamins; D005340:Fibrinogen; D002097:C-Reactive Protein; D001205:Ascorbic Acid