Related Experiment Video
Updated: Jan 16, 2026
In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model
Published on: October 27, 2020
Propofol-supplemented cardioplegia: A multicenter blinded 3-group randomized trial (Propofol for Myocardial
Gianni D Angelini1, Helena J M Smartt2, Katherine Joyce2
1Bristol Heart Institute, University of Bristol, Bristol, United Kingdom.
Insights
Supplementing cardioplegia solution with propofol during coronary artery bypass grafting surgery is safe but not cardioprotective. This randomized controlled trial found no significant reduction in cardiac troponin T levels with propofol use.
Area of Science:
- Cardiology
- Anesthesiology
- Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) with cardiopulmonary bypass and cardioplegic arrest is a standard treatment for coronary artery disease.
- Propofol, an anesthetic agent, has been investigated for potential cardioprotective effects when added to cardioplegia solutions.
Purpose of the Study:
- To evaluate the safety and efficacy of supplementing cardioplegia solutions with varying doses of propofol in adult patients undergoing their first-time CABG surgery.
- To compare high-dose propofol, low-dose propofol, and placebo (saline) in terms of cardiac protection.
Main Methods:
- A blinded, parallel-group randomized controlled trial was conducted across three UK hospitals.
- Participants received either high-dose propofol (12 μg/mL), low-dose propofol (6 μg/mL), or a saline placebo within their cardioplegia solution.
- The primary outcome measure was cardiac troponin T levels assessed over 48 hours post-surgery, with a 12-month follow-up period.
Main Results:
- A total of 240 patients were randomized; 239 were included in the primary analysis.
- No statistically significant difference in cardiac troponin T release at 48 hours was observed between the high-dose propofol, low-dose propofol, and placebo groups (P = .20).
- Adverse events and deaths were reported across all groups, with no clear trend indicating increased risk with propofol.
Conclusions:
- Supplementation of warm blood cardioplegia with propofol at both tested concentrations (6 and 12 μg/mL) is safe for patients undergoing CABG.
- The study found no evidence to support the cardioprotective efficacy of propofol when added to cardioplegia solutions in this patient population.
Objective:
Coronary artery bypass grafting using cardiopulmonary bypass and cardioplegic arrest is an effective treatment for coronary artery disease. Research suggests supplementing the cardioplegia solution with propofol may be cardioprotective. Our aim was to compare the safety and efficacy of supplementing the cardioplegia solution with different doses of propofol in adults undergoing first-time surgery.
Methods:
A blinded, parallel group randomized controlled trial conducted in 3 hospitals in the United Kingdom compared a cardioplegia solution supplemented with high-dose propofol (concentration 12 μg/mL), low-dose propofol (concentration 6 μg/mL), and placebo (saline). Primary outcome was cardiac troponin T measurements over the first 48 hours after surgery. Participants were followed for 12 months.
Results:
In total, 240 participants, median age 66 years, 90% male, were randomly allocated: 78 to high-dose propofol, 80 to low-dose propofol, and 82 to placebo. In total, 239 participants were included in the primary analysis. Geometric mean cardiac troponin release at 48 hours (95% confidence interval) was 145 ng/L (125-168), 162 ng/L (138-191), and 150 ng/L (125-180) in the high-dose propofol, low-dose propofol, and placebo groups, respectively (adjusted geometric mean ratio 1.06; 95% confidence interval, 0.97-1.15; P = .20, for pairwise comparisons between high- and low-dose propofol and between low-dose propofol and placebo). A total of 96 adverse events that prolonged the hospital stay or were life-threatening were reported (33, 26, and 37 in the high-dose propofol, low-dose propofol, and placebo groups, respectively), as well as 4 deaths (1 low-dose propofol group, 3 placebo group).
Conclusions:
Propofol supplementation of warm blood cardioplegia at both the lower and higher concentrations is safe, but there is no evidence to suggest either dose is cardioprotective.
