Objective
Perioperative therapy with antioxidants and metabolic substrates has the potential
to reduce oxidative stress and improve recovery from cardiac surgery, particularly
in elderly and high risk cases. The aim of this study was to assess the effect of
perioperative metabolic therapy at a biochemical, clinical and economic level in cardiac
surgical patients.
Methods
Patients (n = 117, mean age 65 ± 1.0 years, 74% male) undergoing elective coronary artery bypass graft (CABG) and/or
valve surgery in 2004–2006 were randomised to receive in double blinded fashion, while
on the waiting list for surgery (approximately two months) and one month after surgery,
either metabolic therapy (coenzyme Q10, magnesium orotate, lipoic acid, omega-3 fatty acids and selenium) or placebo. Biochemical
and clinical outcomes were assessed.
Results
Cardiac surgery increased oxidative stress and decreased plasma levels of key antioxidants.
Metabolic therapy for a mean of 76 ± 7.5 days increased antioxidant levels preoperatively so that the adverse effect of
surgery on redox status was attenuated. Metabolic therapy reduced plasma troponin
I, 24 hours postoperatively from 1.5 (1.2–1.8) (geometric mean 95% CI) μg/L, to 2.1
(1.8–2.6) μg/L (P = 0.003) and shortened the mean length of postoperative hospital stay by 1.2 days from
8.1 (7.5–8.7) to 6.9 (6.4–7.4) days (P = 0.004) and reduced hospital costs. Metabolic therapy was inexpensive and had no clinically
significant side effects.
Conclusions
Perioperative metabolic therapy for cardiac surgery is safe and inexpensive and is
associated with improved redox status, reduced myocardial damage, and shortened length
of postoperative hospital stay.
Keywords
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Article info
Publication history
Accepted:
June 7,
2010
Received:
May 14,
2010
Identification
Copyright
© 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.
