Key result
Bradykinin preconditioning prior to cardiopulmonary bypass significantly reduced CK-MB release compared to controls (p=0.043) and lowered the IL-8 to IL-10 ratio (p=0.03).
Why the study?
Does exogenous bradykinin infusion before cardiopulmonary bypass reduce myocardial injury and inflammation in patients undergoing isolated CABG?
RCT (n=41)
randomized
Does exogenous bradykinin infusion before cardiopulmonary bypass reduce myocardial injury and inflammation in patients undergoing isolated CABG?
Exogenous bradykinin administration prior to cardiopulmonary bypass in CABG attenuates ischemic myocardial injury and promotes an anti-inflammatory cytokine profile.
BK preconditioning reduced CK-MB release in elective CABG; leaves open meaningful cardioprotection pending larger randomized trials.
OBJECTIVE: The present study was designed to investigate the cardioprotective effect of exogenous administration of bradykinin (BK) in cardiac surgery. METHODS: Forty-one patients who were scheduled for isolated coronary artery bypass grafting (CABG) were randomized into Control group and BK group. BK patients received 25 microg bradykinin infusion for 7 minutes before the cardiopulmonary bypass (CPB). Release of cardiac specific troponin I (TnI) and creatine kinase cardiac isoenzyme (CK-MB) was recorded. Perioperative circulating cytokine interleukin (IL)-6, 8 and 10 were measured. RESULTS: There was no significant difference in TnI between groups. However, BK patients released significantly less CK-MB than the controls (p =0.043). Systemic plasma levels of IL-6, IL-8 and IL-10 increased significantly after reperfusion in both groups as compared with baseline (p <0.05). The ratio of IL-8 to IL-10 was significantly lower in BK groups than in controls (p =0.03). CONCLUSIONS: We conclude that exogenous administration of BK prior to CPB in CABG patients attenuates ischemic myocardial injury. It also shifts the circulating inflammatory cytokine balance towards the anti-inflammatory direction.
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Wang et al. (2008) conducted an RCT in isolated coronary artery bypass grafting (CABG) (n=41). Bradykinin vs. Control was evaluated on Release of cardiac specific troponin I (TnI) and creatine kinase cardiac isoenzyme (CK-MB) (p=0.043). Bradykinin preconditioning prior to cardiopulmonary bypass significantly reduced CK-MB release compared to controls (p=0.043) and lowered the IL-8 to IL-10 ratio (p=0.03).
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