Nicorandil pretreatment and improved myocardial protection during cold blood cardioplegia
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Objective: The present study was designed to assess whether pretreatment with nicorandil enhanced myocardial protection provided by cold (15°C) high-potassium (25 mmol/l) blood cardioplegia during open heart surgery.Methods: Subjects were 40 patients with a variety of acquired heart diseases undergoing cardiac surgery involved cardiopulmonary bypass. They were randomly divided into two groups, 25 pretreated nicorandil (0.3 mg/kg) 30 minutes before aortic cross clamping, 15 not pretreated. After aortic cross clamping, the initial dose of cardioplegic solution (10 ml/kg) was administered through the ascending aorta and supplemental doses of cardioplegia (5 ml/kg) given each 30 minutes thereafter. Preoperative and postoperative cardiac troponin-T, myosin light chain 1 and cardiac enzymes were measured and hemodynamic data recorded.Results: Postoperative serum creatine kinase and myosin light chain 1 were significantly lower in the nicorandil pretreatment group than in controls. Serum glutamic oxalacetic transaminase and troponin-T were lower and cardiac output was higher after surgery in the nicorandil group, although not statistically significantConclusion: This data suggests that pretreatment with nicorandil enhances the myocardial protection achieved by cold blood cardioplegia.
Index wordsnicorandil blood cardioplegia open heart surgery
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