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Cariporide (HOE642) limits S-100B release during cardiac surgery
Martin Scholz1, Gerhard Wimmer-Greinecker, Peter Kleine
1Department of Thoracic and Cardiovascular Surgery, JW Goethe Universität, Frankfurt, Germany. m.scholz@em.uni-frankfurt.de
Journal of Cardiovascular Pharmacology
|February 27, 2003
Summary
The novel drug cariporide (HOE642) may reduce brain injury markers after heart surgery. This study found lower S-100B levels in patients receiving cariporide, suggesting a potential benefit for cerebral swelling.
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- Cardiac surgery with cardiopulmonary bypass (CPB) often leads to transient cerebral swelling.
- Cognitive decline affects 24-57% of patients, with 2-5% experiencing stroke post-CPB.
- Serum S-100B levels, a marker of blood-brain barrier permeability, increase after surgery.
Purpose of the Study:
- To investigate the effect of the Na+/H+ exchange inhibitor cariporide (HOE642) on postoperative S-100B and neuron-specific enolase (NSE) levels.
- To assess cariporide's impact on cerebral swelling markers in high-risk patients undergoing coronary artery bypass grafting (CABG).
Main Methods:
- 53 high-risk patients undergoing CABG were randomized into four groups: placebo, 20 mg, 80 mg, or 120 mg cariporide.
- Serum levels of S-100B, NSE, myeloperoxidase (MPO), and malondialdehyde (MDA) were measured.
- Patients were monitored for transient ischemic attack or stroke postoperatively.
Main Results:
- S-100B levels significantly increased in the placebo group 1 hour post-surgery.
- Cariporide administration (all doses) resulted in significantly lower S-100B levels compared to placebo at 1 hour post-surgery.
- No significant differences were observed in NSE, MPO, or MDA serum levels among the groups.
Conclusions:
- Cariporide (HOE642) may mitigate the increase in S-100B, a marker of cerebral swelling, following cardiac surgery with CPB.
- Further large-scale clinical studies are warranted to confirm cariporide's efficacy in improving neurologic and cognitive outcomes after CPB.
- The findings suggest cariporide as a potential therapeutic agent to protect the brain during cardiac surgery.