title: Effect of dipyridamole on myocardial reperfusion injury: A double-blind randomized controlled trial in patients undergoing elective coronary artery bypass surgery.
abstract: Dipyridamole reduces reperfusion-injury in preclinical trials and may be beneficial in patients undergoing coronary angioplasty, but its effect on patients undergoing coronary artery bypass grafting (CABG) is unknown. We hypothesized that dipyridamole limits myocardial reperfusion-injury in patients undergoing CABG. The trial design was a double-blind trial randomizing between pretreatment with dipyridamole or placebo. In all, 94 patients undergoing elective on-pump CABG were recruited between February 2010 and June 2012. The primary endpoint was plasma high-sensitive (hs-) troponin-I at 6, 12, and 24 hours after reperfusion. Secondary endpoints were the occurrence of bleeding, arrhythmias, need for inotropic support, and intensive care unit length of stay. Finally, 79 patients (33 dipyridamole) were included in the per-protocol analysis. Dipyridamole did not significantly affect postoperative hs-troponin-I (change in plasma hs-troponin I -3% [95% confidence interval -23% to 36%]; P > 0.1). Secondary endpoints did not differ between groups. Dipyridamole prior to CABG does not significantly reduce postoperative hs-troponin release.
authors.affiliation: Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, the Netherlands.|Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: El Messaoudi
authors.affiliation: Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, the Netherlands.|Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: C W
authors.initials: CW
authors.lastname: Wouters
authors.affiliation: Department of Cardio-thoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: H A
authors.initials: HA
authors.lastname: van Swieten
authors.affiliation: Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Pickkers
authors.affiliation: Department of Cardio-thoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Noyez
authors.affiliation: Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: P C
authors.initials: PC
authors.lastname: Kievit
authors.affiliation: Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: E J
authors.initials: EJ
authors.lastname: Abbink
authors.affiliation: Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Rasing-Hoogveld
authors.affiliation: Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: T P
authors.initials: TP
authors.lastname: Bouw
authors.affiliation: Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: J G
authors.initials: JG
authors.lastname: Peters
authors.affiliation: Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: M J H
authors.initials: MJ
authors.lastname: Coenen
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: A R T
authors.initials: AR
authors.lastname: Donders
authors.affiliation: Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, the Netherlands.|Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: N P
authors.initials: NP
authors.lastname: Riksen
authors.affiliation: Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, the Netherlands.|Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: G A
authors.initials: GA
authors.lastname: Rongen
mesh_terms: D000659:AMP Deaminase / Q000235:genetics / Q000378:metabolism; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004176:Dipyridamole / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D005838:Genotype; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D009426:Netherlands; D010597:Pharmacogenetics; D010641:Phenotype; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D002317:Cardiovascular Agents; D018836:Inflammation Mediators; D019210:Troponin I; D004176:Dipyridamole; D000659:AMP Deaminase