Volume 23, Issue 6 (Iranian South Medical Journal 2020)                   Iran South Med J 2020, 23(6): 528-540 | Back to browse issues page

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Eskandari P, Pouladi S, Anvaripour A R. The effects of Vitamin C on Inflammatory Markers and Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Surgery in Bushehr Heart Center: A Randomized Controlled Clinical Trial. Iran South Med J 2020; 23 (6) :528-540
URL: http://ismj.bpums.ac.ir/article-1-1373-en.html
1- Department ofAnesthesia Group, School of Paramedical Sciences, Bushehr University of Medical Sciences, Bu-shehr, Iran
2- Department of Nursing Group, School of Nursing and Midwiferi, Bushehr University of Medical Sciences, Bu-shehr, Iran
3- Department of Anesthesiology Group, School of Medicine ,Bushehr University of Medical Sciences, Bushehr, Iran , a.anvari.p@hotmail.com
Abstract:   (1881 Views)
Background: Coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass pump may cause systemic inflammatory reactions by releasing cytokines which leads to multiple organ failure. Vitamin C has anti-inflammatory and antioxidant properties. The study aimed to determine the effect of vitamin C on inflammatory markers and atrial fibrillation in patients undergoing CABG.
Materials and Methods: In the present single-blind randomized controlled clinical trial, 80 patients were divided to experimental and control groups. The experimental group received vitamin C 2 g IV, and the control group received the same amount (equivalent to 4×5 cc shots) of normal saline IV 10 minutes after induction of anesthesia. Arterial blood samples were taken at specified intervals to assess IL-6 and hsCRP levels. The data were analyzed in SPSS-24.
Results: The changes in IL-6 values at the specific intervals were not statistically significant (P> 0.05). Significant differences were observed in hsCRP levels only 24 hours after CABG. The incidence of atrial fibrillation was not significantly different between the two groups after the intervention.
Conclusion: This study showed that ascorbic acid has no effect on reducing IL6 and hsCRP levels in patients undergoing CABG, and similarly, does not cause a reduction in post-CABG atrial fibrillation.
Full-Text [PDF 501 kb]   (417 Downloads)    
Type of Study: Original | Subject: Cardiovascular System
Received: 2020/02/10 | Accepted: 2020/10/28 | Published: 2020/12/21

1. Rigi F, Feizi A, Naseri M, et al. The Effect Of Foot Reflexology On Anxiety In Patients With Coronary Artery Bypass Surgery Referred To Seyed-Al-Shohada Teaching Hospital, Urmia, 2012. Nurs Midwifery J 2013; 11(8): 578-83. (Persian)
2. Winters Jr WL. Houston Hearts: A History Of Cardiovascular Surgery And Medicine At Houston Methodist Debakey Heart & Vascular Center: From The Michael E. Debakey, MD, Distinguished Lectureship Series, Presented By William L. Winters, Jr., MD, Editor, Methodist Debakey Cardiovascular Journal, On January 19, 2015. Methodist Debakey Cardiovasc J 2015; 11(3 Suppl): 5-17. [DOI:10.14797/mdcj-11-3s1-5]
3. Bahramnezhad F, Asadi Noughabi A, Sief H, et al. Quality Of Life In The Patients With Coronary Bypass Graft. Iran J Nurs Res 2012; 7(26): 34-41. (Persian)
4. Gallagher R, Mckinley S. Stressors And Anxiety In Patients Undergoing Coronary Artery Bypass Surgery. Am J Crit Care 2007; 16(3): 248-57. [DOI:10.4037/ajcc2007.16.3.248]
5. Kaplan JA, Reich DL, Konstadt SN. Kaplan's Cardiac Anesthesia: Expert Consult Premium. 6 th ed. Amsterdam: Elsevier Health Sciences, 2011, 178-92.
6. Edwards JH, Huang DT. Using Pump For Bypass Surgery-On-Off-On Again?. Crit Care 2010; 14(5): 319. [DOI:10.1186/cc9248]
7. Poulsen TD, Andersen LW, Steinbrüchel D, et al. Two Large Preoperative Doses Of Erythropoietin Do Not Reduce The Systemic Inflammatory Response To Cardiac Surgery. J Cardiothorac Vasc Anesth 2009; 23(3): 316-23. [DOI:10.1053/j.jvca.2008.08.018]
8. Laffey JG, Boylan JF, Cheng DC. The Systemic Inflammatory Response To Cardiac Surgery: Implications For The Anesthesiologist. Anesthesiology 2002; 97(1): 215-52. [DOI:10.1097/00000542-200207000-00030]
9. Ercan E, Tengiz I, Duman C, et al. Effect Of Tirofiban On C-Reactive Protein In Non-ST- Elevation Myocardial Infarction. Am Heart J 2004; 147(1): 54-7. [DOI:10.1016/S0002-8703(03)00447-2]
10. Razeghi E, Lessan pezeshki M, Aazaripour A. Evaluation Of Variability Of Acute Phase Proteins In Hemodialysis Patients. Tehran Univ Med J 2006; 64(9): 78-82. (Persian)
11. Raja SG, Dreyfus GD. Modulation Of Systemic Inflammatory Response After Cardiac Surgery. Asian Cardiovasc Thorac Ann 2005; 13(4): 382-95. [DOI:10.1177/021849230501300422]
12. Hill A, Wendt S, Benstoem C, et al. Vitamin C To Improve Organ Dysfunction In Cardiac Surgery Patients-Review And Pragmatic Approach. Nutrients 2018; 10(8): 974. [DOI:10.3390/nu10080974]
13. Paparella D, Yau TM, Young E. Cardiopulmonary Bypass Induced Inflammation: Pathophysiology And Treatment. An Update. Eur J Cardiothorac Surg 2002; 21(2): 232-44. [DOI:10.1016/S1010-7940(01)01099-5]
14. Wannamethee SG, Lowe GD, Rumley A, et al. Associations Of Vitamin C Status, Fruit And Vegetable Intakes, And Markers Of Inflammation And Hemostasis. Am J Clin Nutr 2006; 83(3): 567-74. [DOI:10.1093/ajcn.83.3.567]
15. Padayatty SJ, Katz A, Wang Y, et al. Vitamin C As An Antioxidant: Evaluation Of Its Role In Disease Prevention. J Am Coll Nutr 2003; 22(1): 18-35. [DOI:10.1080/07315724.2003.10719272]
16. Sarzaeem M, Shayan N. Vitamin C In Prevention Of Atrial Fibrillation After Coronary Artery Bypass Graft: Double Blind Randomized Clinical Trial. Tehran Univ Med J 2014; 71(12): 787-93. (Persian)
17. Mazloom Z, Hejazi N, Dabbaghmanesh MH, et al. Effect Of Vitamin C Supplementation On Fasting And Postprandial Oxidative Stress, Inflammatory Markers And Lipid Profiles In Type 2 Diabetic Patients. Iran J Endocrinol Metab 2012; 14(3): 207-14. (Persian) [DOI:10.3923/pjbs.2011.900.904]
18. Hill A, Clasen KC, Wendt S, et al. Effects Of Vitamin C On Organ Function In Cardiac Surgery Patients: A Systematic Review And MetaAnalysis. Nutrients 2019; 11(9): 2103. [DOI:10.3390/nu11092103]
19. Jouybar R, Kabgani H, Kamalipour H, et al. The Perioperative Effect Of Ascorbic Acid On Inflammatory Response In Coronary Artery Bypass Graft Surgery; A Randomized Controlled Trial Coronary Artery Bypass Graft Surgery. Int Cardivasc Res J 2012; 6(1): 13-17.
20. Nyhan D, Johns R, Miller R. Anesthesia For Cardiac Surgery Procedures. Miller R D Anesthesia Philadelphia. Amsterdam: Elsevier, 2005, 1941-2004.
21. Shafiei E, Bahtoei M, Raj P, et al. Effects Of N-Acetyl Cysteine And Melatonin On Early Reperfusion Injury In Patients Undergoing Coronary Artery Bypass Grafting: A Randomized, Open-Labeled, Placebo-Controlled Trial. Medicine 2018; 97(30): e11383. [DOI:10.1097/MD.0000000000011383]
22. Anvaripour A, Shahryari H, Shafiei E, et al. Comparing The Effects Of Propofol And N- Acetylcysteine On Inflammatory Markers After Coronary Artery Bypass Surgery, A Randomized Clinical Trial. Int J Pharm Res 2019; 11: 586-91. [DOI:10.31838/ijpr/2019.11.01.079]
23. Nader ND, Karamano ukian HL, Reedy RL, et al. Inclusion Of Sevoflurane In Cardioplegia Reduces Neutrophil Activity During Cardiopulmonary Bypass. J Cardiothorac Vasc Anesth 2006; 20(1): 57-62. [DOI:10.1053/j.jvca.2005.07.030]
24. Brull DJ, Sanders J, Rumley A, et al. Impact Of Angiotensin Converting Enzyme Inhibition On Post-Coronary Artery Bypass Interleukin 6 Release. Heart 2002; 87(3): 252-5. [DOI:10.1136/heart.87.3.252]
25. Sedighinejad A, Imantalab V, Mirmansouri A, et al. Effects Of Low-Dose Selenium On The Inflammatory Response In Coronary Artery Bypass Graft Surgery: A Clinical Trial. Iran Red Crescent Med J 2016; 18(8): e37918. [DOI:10.5812/ircmj.37918]
26. Golipour Baradari A, Emami Zeydi A, Khademloo M, et al. The Effect of Intravenous Vitamin C on the Level of CRP in Hemodialysis Patients. J Mazandaran Univ Med Sci 2011; 20(80): 55-61. (Persian)
27. Alshafey MK, Elrakhawy HM, Rezk ME, et al. Role Of Ascorbic Acid In Reduction Of The Incidence Of The Atrial Fibrillation In Patients Under B-Blocker And Undergoing Coronary Artery Bypass Graft Operation In Early PostOperative Period. J Egypt Soc Cardio-Thoracic Surg 2017; 25(3): 198-203. [DOI:10.1016/j.jescts.2017.04.003]
28. Papoulidis P, Ananiadou O, Chalvatzoulis E, et al. The Role Of Ascorbic Acid In The Prevention Of Atrial Fibrillation After Elective On-Pump Myocardial Revascularization Surgery: A Single-Center Experience-A Pilot Study. Interact Cardiovasc Thorac Surg 2011; 12(2): 121-4. [DOI:10.1510/icvts.2010.240473]
29. Mousavi M, Eslami M, Sattarzadeh Badkoubeh R, et al. Oral Ascorbic Acid In Combination With Beta Blockers In Prevention Of Atrial Fibrillation After Coronary Artery Bypass Graft. Tehran Univ Med J 2006; 64(10): 23-32. (Persian)
30. Moludi J, Keshavarz S, Pakzad R, et al. Effect Of Vitamin C Supplementation In The Prevention Of Atrial Fibrillation. Tehran Univ Med J 2016; 73(11): 791-7. (Persian)
31. Rostami AR, Sharifi M, Kamali AR, et al. Evaluation Of The Effect Of Combination Of N-Acetylcysteine And Vitamin C On Improving Outcomes Following CABG. J Arak Univ Med Sci 2016; 18(10): 29-39. (Persian)

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