High-dose cimetidine reduces proinflammatory reaction after cardiac surgery with cardiopulmonary bypass

Area of Science:

• Immunology
• Cardiovascular Surgery
• Pharmacology

Background:

• Cimetidine, commonly used for gastric ulcers, is known to enhance cellular immunity.
• The perioperative inflammatory response following cardiac surgery with cardiopulmonary bypass (CPB) is a significant clinical concern.

Purpose of the Study:

• To investigate the effect of cimetidine on the perioperative proinflammatory response in patients undergoing cardiac surgery with CPB.
• To assess whether cimetidine administration can modulate key inflammatory markers and immune parameters post-surgery.

Main Methods:

• A randomized controlled trial involving 40 patients undergoing elective coronary artery bypass graft surgery with CPB.
• Patients were assigned to either a cimetidine (C) group (n=20) or a no-treatment (N) control group (n=20).
• Plasma levels of neutrophil elastase, IL-6, IL-8, C-reactive protein, creatine-kinase-MB, leukocyte counts, lymphocyte recovery ratio, and oxygenation index were analyzed over time.

Main Results:

• Cimetidine significantly inhibited plasma levels of neutrophil elastase and IL-8 at 2 hours post-CPB termination.
• The cimetidine group exhibited a higher lymphocyte recovery ratio and lower C-reactive protein on postoperative day 5.
• Patients receiving cimetidine experienced a shorter intubation time compared to the control group.

Conclusions:

• Cimetidine may serve as a therapeutic agent to mitigate surgical stress following cardiac surgery with CPB.
• Administration of cimetidine appears to augment the immune system's response in the perioperative period.
• The findings suggest a potential role for cimetidine in improving patient outcomes after complex cardiac procedures.