Evaluation of Vasodilatory Effect of Nitroglycerin in Cardioplegia Solution on Patients Undergoing Coronary Artery Bypass Graft Surgery

Abstract

INTRODUCTION: This study aimed to evaluate the vasodilatory effect of nitroglycerin (NTG) in cardioplegia solution on changes in troponin I and creatine phosphokinase-MB (CPK-MB) levels during coronary artery bypass graft (CABG) surgery. METHOD: A randomized controlled double-blind clinical trial was performed on 44 patients who were candidates for CABG surgery. These patients were divided into two groups. In the first group (NTG group), 3 mg/kg NTG was added to the cardioplegia solution, while 10 cc placebo (distilled water) was added to the cardioplegia solution in the second group (control group). Troponin I and CPK-MB levels were then assessed before and after the surgery. RESULTS: In this study, 72.7 and 27.3 of patients in the NTG group and 68.2 and 31.8 of patients in the control group were male and female, respectively. In addition, 9.1 within the age range of 40-50 years, 27.3 within the age range of 50-60 years, and 63.6 within the age range of more than 60 years were present in the NTG group. Moreover, 18.2 within the age range of 40-50 years, 36.4 within the age range of 50-60 years, and 45.5 within the age range of more than 60 years were present in the control group. Although the mean cardiopulmonary bypass (CPB) and cross-clamp time was insignificantly higher in the NTG group compared to the control group. In addition, troponin I and CPK-MB levels after surgery in the NTG group with the mean of 2090.68 +/- 1856.07 and 97.27 +/- 38.17 were significantly lower than those of the control group with the mean of 2697.02 +/- 5586.56 and 137.95 +/- 227.99, respectively (P-value <0.05). CONCLUSION: According to the results of this study, although troponin I and CPK-MB levels increased significantly after CABG surgery, this increase was significantly lower in the intervention group compared to the control group following the administration of NTG.