Effects of Inorganic Nitrate on Ischaemia-reperfusion Injury After Coronary Artery Bypass Surgery: a Randomised Controlled Trial

Overview

Journal Br J Anaesth

Publisher Elsevier

Specialty Anesthesiology

Date 2021 Aug 17

PMID 34399982

Citations 2

Authors

Karin E Eriksson

Fredrik Eidhagen

Jan Liska

Anders Franco-Cereceda

Jon O Lundberg

Eddie Weitzberg

Affiliations

Soon will be listed here.

Abstract

Background: Nitric oxide (NO) is an important signalling molecule in the cardiovascular system with protective properties in ischaemia-reperfusion injury. Inorganic nitrate, an oxidation product of endogenous NO production and a constituent in our diet, can be recycled back to bioactive NO. We investigated if preoperative administration of inorganic nitrate could reduce troponin T release and other plasma markers of injury to the heart, liver, kidney, and brain in patients undergoing cardiac surgery.

Methods: This single-centre, randomised, double-blind, placebo-controlled trial included 82 patients undergoing coronary artery bypass surgery with cardiopulmonary bypass. Oral sodium nitrate (700 mg×2) or placebo (NaCl) were administered before surgery. Biomarkers of ischaemia-reperfusion injury and plasma nitrate and nitrite were collected before and up to 72 h after surgery. Troponin T release was our predefined primary endpoint and biomarkers of renal, liver, and brain injury were secondary endpoints.

Results: Plasma concentrations of nitrate and nitrite were elevated in nitrate-treated patients compared with placebo. The 72-h release of troponin T did not differ between groups. Other plasma biomarkers of organ injury were also similar between groups. Blood loss was not a predefined outcome parameter, but perioperative bleeding was 18% less in nitrate-treated patients compared with controls.

Conclusion: Preoperative administration of inorganic nitrate did not influence troponin T release or other plasma biomarkers of organ injury in cardiac surgery.

Clinical Trial Registration: NCT01348971.

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