Deferoxamine infusion during coronary artery bypass grafting ameliorates lipid peroxidation and protects the...

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Pharmacology

Background:

• Oxygen free radical scavengers like deferoxamine (DEF) have shown promise in enhancing myocardial protection during cardioplegia.
• Previous reports suggest improved post-ischaemic recovery with DEF, but its efficacy in reducing reperfusion injury during coronary artery bypass grafting (CABG) requires further investigation.

Purpose of the Study:

• To evaluate the short- and long-term effectiveness of intravenous deferoxamine (DEF) infusion in reducing myocardial reperfusion injury in patients undergoing CABG.
• To assess the impact of DEF on oxygen free radical production and cardiac function post-CABG.

Main Methods:

• A randomized study involving 45 male patients undergoing CABG, allocated to receive either 4g of DEF intravenously for 8 hours or a dextrose placebo.
• Measurements included haemodynamic monitoring, thiobarbituric acid reactive substances (TBARS) to quantify free radical production, and left ventricular ejection fraction (EF) and wall motion score index (WMSI) assessed pre- and post-CABG, and at 12-month follow-up.

Main Results:

• DEF infusion significantly reduced TBARS levels compared to placebo (2.4 vs 4.8 nmol/mL, P=0.01), indicating decreased oxygen free radical production.
• Patients receiving DEF showed a significantly greater increase in EF (8.8% vs 1.3%, P=0.008) and a larger decrease in WMSI (-0.7 vs -0.2, P=0.0001) post-CABG.
• At 1-year follow-up, DEF infusion provided more significant myocardial protection in patients with a lower pre-operative EF.

Conclusions:

• Intravenous deferoxamine (DEF) infusion effectively mitigates oxygen free radical production and protects the myocardium against reperfusion injury in CABG patients.
• DEF demonstrates a greater protective benefit in patients with lower baseline left ventricular ejection fraction (EF).