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Braz J Cardiovasc Surg. 2019 Dec 1;34(5):517-524. doi: 10.21470/1678-9741-2018-0312.

The Effect of High-Dose Vitamin C on Biochemical Markers of Myocardial Injury in Coronary Artery Bypass Surgery.

Author information

1
Shiraz University of Medical Sciences Blood Circulation Technology Shiraz Iran Blood Circulation Technology, Shiraz University of Medical Sciences, Shiraz, Iran.
2
Shiraz University of Medical Sciences Department of Heart Surgery Shiraz Iran Department of Heart Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
3
Shiraz University of Medical Sciences Anesthesiology Research Center Shiraz Iran Anesthesiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
4
Torbat Heydarieh University of Medical Sciences Department of Public Health Torbat Heydarieh Iran Department of Public Health, Torbat Heydarieh University of Medical Sciences, Torbat Heydarieh, Iran.
5
Shiraz University of Medical Sciences Department of Anesthesiology Shiraz Iran Department of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

OBJECTIVE:

To evaluate the effect of high-dose vitamin C on cardiac reperfusion injury and plasma levels of creatine kinase-muscle/brain (CK-MB), troponin I, and lactate dehydrogenase (LDH) in patients undergoing coronary artery bypass grafting (CABG).

METHODS:

This is a double-blind randomized clinical trial study. Fifty patients (50-80 years old) who had CABG surgery were selected. The intervention group received 5 g of intravenous vitamin C before anesthesia induction and 5 g of vitamin C in cardioplegic solution. The control group received the same amount of placebo (normal saline). Arterial blood samples were taken to determine the serum levels of CK-MB, troponin I, and LDH enzymes. Left ventricular ejection fraction was measured and hemodynamic parameters were recorded at intervals.

RESULTS:

High doses of vitamin C in the treatment group led to improvement of ventricular function (ejection fraction [EF]) and low Intensive Care Unit (ICU) stay. The cardiac enzymes level in the vitamin C group was lower than in the control group. These changes were not significant between the groups in different time intervals (anesthesia induction, end of bypass, 6 h after surgery, and 24 h after surgery) for CK-MB, LDH, and troponin I. Hemodynamic parameters, hematocrit, potassium, urinary output, blood transfusion, arrhythmia, and inotropic support showed no significant difference between the groups.

CONCLUSION:

Vitamin C has significantly improved the patients' ventricular function (EF) 72 h after surgery and reduced the length of ICU stay. No significant changes in cardiac biomarkers, including CK-MB, troponin I, and LDH, were seen over time in each group.

IRCT CODE:

IRCT2016053019470N33.

KEYWORDS:

Arrhythmias, Cardiac; Ascorbic Acid; Biomarkers; Cardioplegic Solutions; Coronary Artery Bypass; Stroke Volume; Ventricular Function; Vitamins

PMID:
31719005
PMCID:
PMC6852463
DOI:
10.21470/1678-9741-2018-0312
[Indexed for MEDLINE]
Free PMC Article

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