Effects of Remote Ischemic Preconditioning on Antioxidant Capacity and Lipid Peroxidation in Patients Undergoing Coronary Artery Bypass Grafting in Tehran Heart Center

Document Type : Original Article

Authors

1 Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran.

2 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

3 Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, IR Iran.

4 Department of Anesthesiology, Iran University of Medical Sciences, Tehran, IR Iran.

Abstract

Background: Remote ischemic preconditioning (RIPC) may improve outcomes in ischemia/reperfusion injury (IRI) by improving antioxidant defense. We investigated total antioxidant capacity (TAC) and malondialdehyde (MDA) content as markers of lipid peroxidation.
 
Methods: The present randomized clinical trial allocated 50 coronary artery bypass graft (CABG) patients with cardiopulmonary bypass at Tehran Heart Center to 2 groups: RIPC and control (25 patients each). Clinical biochemistry parameters, TAC, and MDA were measured at 3 time points: post-anesthesia induction (before skin incision), immediately post-CPB, and 24 hours post-ICU admission.
 
Results: Increased transfusions of packed cells in the ICU and higher plasma MDA levels at post-CPB were observed in the control group. Additionally, significantly higher plasma TAC levels were observed at 24 hours post-ICU in the RIPC group.
 
Conclusions: RIPC protects against IRI in CABG on CPB by reducing lipid peroxidation and elevating antioxidant defense. RIPC could be integrated into CABG to reduce IRI adverse outcomes. (Iranian Heart Journal 2023; 24(1): 15-21)

Keywords


  1. Sarrafzadegan N, Mohammmadifard N. Cardiovascular disease in Iran in the last 40 years: prevalence, mortality, morbidity, challenges and strategies for cardiovascular prevention. Archives of Iranian medicine. 2019; 22(4):204-10.
  2. Wang H, Lyu Y, Liao Q, Jin L, Xu L, Hu Y, et al. Effects of Remote Ischemic Preconditioning in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery. Frontiers in Physiology. 2019; 10(495).
  3. Gorjipour F, Dehaki MG, Totonchi Z, Hajimiresmaiel SJ, Azarfarin R, Pazoki-toroudi H, et al. Inflammatory cytokine response and cardiac troponin I changes in cardiopulmonary bypass using two cardioplegia solutions; del Nido and modified St. Thomas’: a randomized controlled trial. Perfusion. 2017; 32(5):394-402.
  4. Mehrabanian MJ, Dehghani Firoozabadi M, Ahmadi Tafti SH, Forouzan Nia SK, Najafi A, Mortazian M, et al. Clinical Outcomes and Electrolyte Balance Factors in Complex Cardiac Operations in Adults; Del Nido® Versus Custodiol® Cardioplegia Solutions: A Randomized Controlled Clinical Trial. Iranian Red Crescent medical journal. 2018; 20(4):e64648.
  5. Gorjipour F, Hosseini-Gohari L, Alizadeh Ghavidel A, Hajimiresmaiel SJ, Naderi N, Darbandi Azar A, et al. Mesenchymal stem cells from human amniotic membrane differentiate into cardiomyocytes and endothelial-like cells without improving cardiac function after surgical administration in rat model of chronic heart failure. Journal of cardiovascular and thoracic research. 2019; 11(1):35-42.
  6. Gorjipour F, Saeedzadeh T, Toloueitabar Y, Kachoueian N, Bahlouli Ghashghaei S, Mortazian M, et al. Remote ischemic preconditioning effects on inflammatory markers and myocardial protection in coronary artery bypass graft surgery. Perfusion. 2020:0267659120979293.
  7. Gorjipour F, Totonchi Z, Gholampour Dehaki M, Hosseini S, Tirgarfakheri K, Mehrabanian M, et al. Serum levels of interleukin-6, interleukin-8, interleukin-10, and tumor necrosis factor-α, renal function biochemical parameters and clinical outcomes in pediatric cardiopulmonary bypass surgery. Perfusion. 2019; 34(8):651-9.
  8. Sadeghpour Tabaei A, Mortazian M, Yaghoubi A, Gorjipour F, Arasteh Manesh S, Totonchi Z, et al. Modified Ultrafiltration in Coronary Artery Bypass Grafting: A Randomized, Double-Blinded, Controlled Clinical Trial. Iranian Red Crescent medical journal. 2018; 20(5):e66187.
  9. Amani H, Mostafavi E, Alebouyeh MR, Arzaghi H, Akbarzadeh A, Pazoki-Toroudi H, et al. Would Colloidal Gold Nanocarriers Present An Effective Diagnosis Or Treatment For Ischemic Stroke? International journal of nanomedicine. 2019; 14:8013-31.
  10. Pazoki-Toroudi HR, Hesami A, Vahidi S, Sahebjam F, Seifi B, Djahanguiri B. The preventive effect of captopril or enalapril on reperfusion injury of the kidney of rats is independent of angiotensin II AT1 receptors. Fundamental & clinical pharmacology. 2003; 17(5):595-8.
  11. Zarch AV, Toroudi HP, Soleimani M, Bakhtiarian A, Katebi M, Djahanguiri B. Neuroprotective effects of diazoxide and its antagonism by glibenclamide in pyramidal neurons of rat hippocampus subjected to ischemia-reperfusion-induced injury. The International journal of neuroscience. 2009; 119(9):1346-61.
  12. Khan MS, Islam MY, Ahmed MU, Bawany FI, Khan A, Arshad MH. On pump coronary artery bypass graft surgery versus off pump coronary artery bypass graft surgery: a review. Global journal of health science. 2014; 6(3):186-93.
  13. Kunt AS, Selek S, Celik H, Demir D, Erel O, Andac MH. Decrease of total antioxidant capacity during coronary artery bypass surgery. The Mount Sinai journal of medicine, New York. 2006; 73(5):777-83.
  14. Farsad BF, Janipour M, Totonchi Z, Gorjipour F, Omid SO. Effects of dexmedetomidine on surgical stress responses at patients under CABG. Biosciences Biotechnology Research Asia. 2016; 13(3):1537-45.
  15. Rodrigo R, Korantzopoulos P, Cereceda M, Asenjo R, Zamorano J, Villalabeitia E, et al. A randomized controlled trial to prevent post-operative atrial fibrillation by antioxidant reinforcement. Journal of the American College of Cardiology. 2013; 62(16):1457-65.
  16. Rodrigo R, Prieto JC, Castillo R. Cardioprotection against ischaemia/reperfusion by vitamins C and E plus n-3 fatty acids: molecular mechanisms and potential clinical applications. Clinical science (London, England : 1979). 2013; 124(1):1-15.
  17. Maurya PK, Kumar P, Chandra P. Biomarkers of oxidative stress in erythrocytes as a function of human age. World journal of methodology. 2015; 5(4):216-22.