The effectiveness of succinate cardioprotection during vascular surgery in high cardiac risk patients

Abstract

The objective was to study the occurrence of perioperative cardiovascular complications (CVС) and clinical and laboratory cardioprotection parameters in patients treated with an infusion of a succinate-containing drug during the intraoperative period of vascular surgery.Materials and methods. The study involved 120 patients with high cardiac risk (revised cardiac risk index > 2, risk of perioperative myocardial infarction or cardiac arrest > 1 %) who underwent elective vascular surgery. Patients were randomly divided into two groups. Patients of group 1 received intraoperative infusion of succinate-containing drug at a dose of succinate 0.35 [0.26–0.40] mg/kg/min– 1. Group II was a control group. In the perioperative period, the occurrence of perioperative CVC, the blood level of the N-terminal segment of natriuretic B-type prohormone (NT-proBNP) and cardiospecific troponin I (cTnI) were analyzed.Results. Perioperative CVC was registered in 11 (18.3 %) patients of group I and in 11 (18.3 %) patients of group II (p = 1.0). The level of NT-proBNP in patients of group I and group II was 207 [160–300] pg/ml and 229 [150.6–298.9] pg/ml (p = 0.817) before surgery, 234.2 [155.9–356] and 277 [177.7–404] pg/ml ( p = 0.207) after surgery and 240.5[149.3–306] and 235.5 [133–495.1] pg/ml ( p = 0.979) before discharge from the hospital. An increased level of cTnI after surgery was recorded in 4 (6.7 %) patients of group I and in 1 (1.7 %) patient ( p = 0.364) of group II.Conclusion. Intraoperative infusion of succinate-containing drug does not affect the occurrence of CVC in patients with high cardiac risk during vascular surgery. The succinate-containing drug does not affect the preoperative level of NT-proBNP and cTnI.

Keywords

• cardioprotection
• succinate
• cardiovascular complications
• vascular surgery
• cardiac risk
• non-cardiac surgery
• cytoflavin