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Published on: September 15, 2023
Rosuvastatin Lowers Systemic Inflammatory Response in Coronary Artery Bypass Graft Accompanied by Cardiopulmonary
Ibrahim M Ozguler1, Oktay Burma, Ayhan Uysal
1. drmuratozg@hotmail.com.
Insights
Rosuvastatin administration after cardiopulmonary bypass (CPB) in coronary bypass surgery reduced inflammatory markers like IL-6 and hs-CRP. This may help mitigate complications associated with CPB-induced systemic inflammatory response.
Area of Science:
- Cardiovascular Surgery
- Pharmacology
- Immunology
Background:
- Cardiopulmonary bypass (CPB) often triggers a systemic inflammatory response, potentially leading to severe complications.
- Key indicators of this response include complement activation and altered levels of cytokines and acute-phase reactants.
Purpose of the Study:
- To investigate the effects of rosuvastatin on key inflammatory markers following CPB.
- Specifically examined were levels of interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-18 (IL-18), and high-sensitivity C-reactive protein (hs-CRP).
Main Methods:
- A randomized controlled trial involving 50 patients undergoing coronary artery bypass grafting.
- The treatment group (n=25) received 20 mg of rosuvastatin daily from preoperative day 7 to postoperative day 28; the control group (n=25) received a placebo.
- Blood samples were collected at six time points, from pre-anesthesia to postoperative day 28.
Main Results:
- Rosuvastatin significantly reduced IL-6 levels at postoperative time points (T4, T5, T6).
- Elevated IL-10 levels were observed at T3 and T4, while IL-18 levels increased at multiple time points.
- Rosuvastatin also lowered hs-CRP and cholesterol levels by postoperative day 28 (T6).
Conclusions:
- Perioperative rosuvastatin administration (20 mg/day) may reduce systemic inflammatory response complications after CPB during coronary bypass surgery.
- The findings suggest a potential benefit in managing intraoperative inflammation and associated risks.
Purpose:
Cardiopulmonary bypass (CPB) is commonly associated with a systemic inflammatory response that may lead to severe complications. Classic signs of systemic inflammatory response syndrome are complement activation and changes in cytokine and acute phase reactant levels. The effects of rosuvastatin after CPB on interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-18 (IL-18) and High Sensitivity C-Reactive Protein (hs-CRP) levels were investigated.
Methods:
Thirty-seven male and thirteen female patients (total=50) aged 42 to 78 years, who had coronary bypass surgery due to coronary artery disease were randomly divided into two groups. The 25 patients in the control group were administered placebos. The 25 in the treatment group were administered 20 mg rosuvastatin tablets daily between preoperative day 7 and postoperative day 28. Blood samples were taken at six time points; before induction of anesthesia (T1), during CPB (T2), five minutes after removal of cross clamp (T3), after protamine infusion (T4), postoperative day three (T5) and postoperative day 28 (T6). Data points were expressed as mean ± standard deviation (SD).
Results:
Rosuvastatin lowered IL-6 levels at T4, T5 and T6 time points (T4, T5, T6 p < 0.05), and elevated IL-10 levels at T3 and T4 (T3, T4 p < 0.05). IL-18 levels were also elevated at multiple time points. Rosuvastatin also lowered hs-CRP levels and cholesterol levels at T6 (p < 0.05).
Conclusion:
Administering 20 mg/day of rosuvastatin between preoperative day 7 and postoperative day 28 may result in fewer complications in certain (especially intraoperative) cases of systemic inflammatory response caused by the CPB technique used in coronary bypass surgery.
