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Published on: September 15, 2023
Effect of Multi-trace Elements Supplementation on Biochemical Markers and Postoperative Outcome in Patients
Mehran Amirizadeh1, Gohar Eslami2, Negar Shafaei-Bajestani3
1Department of Pharmacotherapy, Faculty of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran.
Insights
Trace element supplementation after coronary artery bypass graft (CABG) surgery may improve patient outcomes. Supplementing with trace elements like zinc and copper helped reduce C-reactive protein levels and potentially mortality in CABG patients.
Area of Science:
- Cardiology
- Nutritional Biochemistry
- Surgical Outcomes
Background:
- Coronary Artery Bypass Graft (CABG) surgery is a vital intervention for patients with Coronary Artery Disease (CAD).
- Low serum levels of essential trace elements are associated with adverse outcomes in patients undergoing CABG.
- Identifying interventions to mitigate these risks is crucial for improving patient prognosis.
Purpose of the Study:
- To evaluate the impact of trace element supplementation on postoperative recovery following CABG.
- To assess the effect of Addamel©, a trace element mixture, on key clinical and biochemical markers post-CABG.
Main Methods:
- A randomized clinical trial involving 200 patients undergoing on-pump CABG.
- Participants received either Addamel© (trace elements) or isotonic saline for 3 days post-surgery.
- Postoperative measurements included plasma concentrations of zinc, selenium, copper, manganese, and iron, alongside highly sensitive C-reactive Protein (hs-CRP).
Main Results:
- Trace element supplementation led to increased plasma copper and manganese levels by day 3.
- While hs-CRP increased initially in both groups, it decreased by day 2 in the supplemented group.
- A trend towards lower 30-day mortality was observed in the Addamel© group, with significant negative correlations between plasma zinc and mortality, and pre-operative CRP and SOFA score.
Conclusions:
- Trace element supplementation appears beneficial for patients undergoing CABG.
- Administering Addamel© post-CABG may help maintain serum trace element concentrations and reduce plasma CRP levels.
- Further research is warranted to confirm the impact on mortality and other clinical endpoints.
Background:
Coronary Artery Bypass Graft (CABG) surgery is employed to increase the lifespan of patients with Coronary Artery Disease (CAD). The low serum levels of essential elements have a negative effect on patients undergoing CABG.
Objective:
This clinical trial aimed to investigate the effect of trace elements supplements on postoperative outcomes after coronary artery bypass graft.
Methods:
Two hundred patients underwent on-pump CABG to randomly receive either Addamel©, which contains essential trace elements, or isotonic saline for 3 days. We measured postoperative plasma Zn, Se, Cu, Mn, Se, and Fe concentrations, and the levels of highly sensitive C-reactive Protein (hs-CRP) on days 0, 1, and 2. Duration of hospital and Intensive Care Unit (ICU) stay, 30-day mortality, and the incidence of Arterial Fibrillation (AF) have been evaluated as secondary outcomes.
Results:
In the supplemented group, the plasma levels of Cu and Mn increased by day 3, and plasma hs-CRP increased by day 1 in both groups, but it decreased in patients who received trace elements supplementation on day 2. The Addamel group had a lower mortality rate, though the difference did not reach a significant level. There was a significant negative correlation observed between plasma Zn level and 30-day mortality, along with another significant negative link between plasma CRP level before operation and Sepsis-related Organ Failure Assessment (SOFA) score. Other measured parameters were similar between the intervention and placebo groups.
Conclusion:
The patients undergoing CABG appeared to benefit from trace element supplementation. A brief period of Addamel administration following CABG could prevent a decrease in the serum concentration of trace elements and reduce the circulating plasma CRP.
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