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


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.


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)


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