Cardioprotective Effects of Phosphocreatine in Vascular Surgery

The pharmacologic use of phosphocreatine (Pcr) in cardiology and cardiac surgery, along with other so-called metabolic drugs, to prevent the ultrastructural and clinical effects of ischemia on the myocardium has been the aim of many studies during recent years. To evaluate the protective action of Pcr in a series of surgical vascular patients with an associated heart disease, the authors have included in this study 62 patients undergoing vascular operations and have randomly divided them into a Pcr-treated group and a control group. The cardiac index (L x min-1 x m-2), the use of inotropic drugs (number of patients), the EKG alterations (ST ≥ 2 mm, arrhythmias) with a Holter registration, and the measurement of ejection fraction by 2D-Echo Doppler analysis were examined. A statistically significant improvement in the central hemodynamics during the immediate postoperative course was observed in the Pcr group, preserving a good left ventricular function and preventing severe arrhythmias. The results revealed that the use of Pcr induced a more efficacious protection of the myocardium with an improved functional recovery, a positive inotropic effect, and an antiarrhythmic action. Nevertheless there is need for further studies to demonstrate the real benefit of using Pcr for myocardial protection in vascular surgery.