Preoperative oral pentoxifylline in case of coronary artery bypass grafting with left ventricular dysfunction (ejection fraction equal to/less than 30%)
نویسندگان
چکیده
OBJECTIVE Most coronary artery bypass grafts are done by applying cardiopulmonary bypass, which usually induces unwanted inflammatory reactions and impairs the outcomes. In order to minimize the perilous response of cardiopulmonary bypass, pentoxifylline was getting used orally. METHODS In a prospective, placebo-controlled, randomized clinical trial, 178 coronary artery bypass graft candidates with ejection fraction lower/equal to 30%, divided into two equal groups (pentoxifylline and control), participated in the study. Pentoxifylline patients received 400 mg pentoxifylline 3 times a day for 3 days before operation. The outcomes were compared between groups using student's t-test, Mann-Whitney U-test, Pearson chi-square, or Fisher's exact test. RESULTS Pentoxifylline administration did not significantly affect troponin-T (p=0.68), but it reduced tumor necrosis factor-α (p=0.01) and interleukin-6 (p=0.01). It improved left ventricular ejection fraction significantly (p=0.01). White blood cell and platelet counts, hemoglobin, and hematocrit were not influenced by pentoxifylline. The drug did not affect blood urea nitrogen and creatinine, occurrence of renal failure, cerebrovascular accidents, and in-hospital mortality rate. The need for an intra-aortic balloon pump, cardiopulmonary bypass, and aortic cross-clamp times were not affected, either. Pentoxifylline decreased the intensive care unit stay (p<0.001), ventilation time, 10.4 hours in the pentoxifylline group against 14.7 hours in the control group (p=0.01), and the requirement of inotropic agents (p=0.02) and blood transfusion (p=0.01). CONCLUSION Pentoxifylline has more beneficial potencies in reducing adverse events after coronary artery bypass graft using cardiopulmonary bypass, than what are known.
منابع مشابه
Preoperative oral pentoxifylline in case of coronary artery bypass grafting with left ventricular dysfunction (ejection fraction equal to/less than 30%)
متن کامل
Effects of pentoxifylline on blood transfusion
We congratulate the authors for their study entitled “Preoperative oral pentoxifylline in case of coronary artery bypass grafting with left ventricular dysfunction (ejection fraction equal to/less than 30%),” published in Anatol J Cardiol 2015; 15: 1014-9. This study evaluated the feasibilty of pentoxifylline when patients with low ejection fraction are considered (1). Systemic inflammatory res...
متن کاملPrediction of Changes in Left Ventricular Ejection Fraction after Off-Pump Coronary Artery Bypass Grafting Surgery by Myocardial Perfusion Single-Photon Emission Computed Tomography
Introduction: Left ventricular ejection fraction (LVEF) is considered to be the single most important prognostic factor in patients with previous myocardial infarction. LVEF is not improved in all patients after coronary artery bypass grafting (CABG). This study aimed to assess the possibility of prediction of LVEF changes after CABG using myocardial perfusion gated signle photon emission compu...
متن کاملHigh-risk Coronary Artery Bypass Grafting and Mitral Valve Replacement in a HIV Positive Patient
Certain subsets of high-risk mitral valve patients are not suitable candidates for transcatheter therapies. The objective of this report is to present a young patient with combined mitral valve and coronary artery disease to illustrate these challenges.In this report, we present a 47-year-old man with longstanding HIV infection who was referred with severe mitral regurgitation (MR) and profound...
متن کاملSurgical Myocardial Revascularization of Patients with Ischemic Cardiomyopathy and Severe Left Ventricular Disfunction
OBJECTIVE To determine long-term survival, identify preoperative factors predictive of a favorable outcome, and assess functional improvement after coronary artery bypass grafting in patients with advanced left ventricular dysfunction. METHODS Between 1995 and 2001, 244 patients who underwent coronary artery bypass grafting and had a preoperative left ventricular ejection fraction less than o...
متن کامل