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Studying the Effect of Preoperative Nicorandil on Myocardial Injury After Open Heart Surgery
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M Shahzamani1   , A Hosseini1 , A Salahi Ardakani2 |
1- Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
2- Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran , perfusion1985@gmail.com |
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Abstract: (631 Views) |
Background & aim: Inadequate myocardial protection and intraoperative myocardial injury (PMI) are important and common complications in various cardiac surgical procedures. Therefore, the aim of the present study was to determine and investigate the effect of preoperative nicorandil on myocardial injury after open heart surgery.
Methods: The present single-blinded clinical trial analysis study was conducted in 2023 at Shahid Chamran Educational and Medical Center - Isfahan. The participants were 70 patients (35 in each group) who were randomly assigned to two control and intervention groups for cardiac surgery. Based on the computer-based randomization, they were divided into two intervention and control groups. In the intervention group, in addition to the usual treatments, oral nicorandil tablets were administered at a dose of 10 mg 3 times. The patients were anesthetized in a similar way and operated by a team. After surgery, the patients were evaluated and compared in terms of clinical criteria including troponin eight and twenty-four hours after surgery, the anatomy of the patient's coronary arteries after counting, the duration of hospitalization in the ICU, the time required for mechanical ventilation (ventilator), the occurrence of myocardial infarction, the occurrence of new arrhythmia, the need for the use of intra-aortic balloon pump (IABP), and mortality in the two groups. The collected data were analyzed using t-test, chi-square, Wilcoxon, and Mann-Whitney statistical tests.
Results: The results indicated that in the control group, 11.4% were female and 88.6% were male, with an average age 58.42±8.46 years, and in the intervention group, 42.9% were female and 57.1% were male with The average age 59.31± 6.88 years. Also, 50% of the people participating in the study were in the age range of 60-70 years). Respectively the average EF in the control group was 54.42±8.43. At 8 hours and 24 hours after the operation, troponin in the intervention group (1.36±0.8 and 1.56±0.83) was significantly higher than the control group (2.06±0.75 and 2.44±0.91 (p<0.05.
Conclusion: The results of the present study indicated that the use of NICD protected the myocardium in patients undergoing heart bypass surgery. In addition, NICD administration had the potential to reduce the incidence of postoperative arrhythmia, but the results were not significant. Also, the average increase in troponin in the intervention group after open heart surgery was lower than the average increase in troponin in the control group.
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| Keywords: Heart surgery, Cardioplegia, Myocardial damage |
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Full-Text [PDF 903 kb]
(113 Downloads)
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Type of Study: Research |
Subject:
Special
Received: 2024/07/8 | Accepted: 2024/09/22 | Published: 2024/10/6
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