Farshidianfar Melika, Ardekani Ali, Tabrizi Reza, Lankarani Kamran B, Taherifard Erfan, Abdollahi Ashkan, Azizi Arezou, Akbari Maryam
Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Medical Sciences, Islamic Azad University, Mashhad, Iran.
Cardiol Ther. 2023 Mar;12(1):11-20. doi: 10.1007/s40119-022-00287-1. Epub 2022 Nov 9.
The antiinflammatory and antioxidative effects of melatonin have been established in recent years. Several studies indicate that oxidative stress and inflammation are key drivers of post-coronary artery bypass graft (CABG) surgery complications. In the present study, we aimed to investigate the effects of melatonin on cardiac injury and inflammatory biomarkers in CABG candidates.
Embase, Medline/PubMed, Web of Science, Scopus, and the Cochrane library were searched up to 5 June 2022. All randomized controlled trials examining cardiac injury and inflammatory biomarkers of CABG patients who received melatonin were included. The random-effects model was utilized to perform the analysis.
A total of 947 citations were retrieved through database searches. Finally, five articles (six trials with 342 patients) were included after the screening. Melatonin supplementation led to a significant reduction in cardiac troponin I (CTnI) [weighted mean difference(WMD): -2.28 ng/ml; 95% CI -2.87, -1.69; P < 0.01; I: 91.25%] and high sensitivity-C reactive protein (hs-CRP) levels (WMD: -0.62 mg/L; 95% CI -0.73, -0.5; P < 0.01; I: 99.98%) in patients undergoing CABG surgery. We found a nonsignificant decrease in creatine kinase isoenzyme muscle/brain (CK-MB) levels (WMD: -2.87 ng/ml; 95% CI -5.97, 0.23; P = 0.07; I: 99.98%) after melatonin supplementation. No publication bias was found according to Egger's test.
Melatonin supplementation may be useful in reducing cardiac injury and inflammatory biomarkers in CABG candidates. Future studies should investigate the clinical significance of these findings.
褪黑素的抗炎和抗氧化作用近年来已得到证实。多项研究表明，氧化应激和炎症是冠状动脉旁路移植术（CABG）术后并发症的关键驱动因素。在本研究中，我们旨在探讨褪黑素对CABG候选患者心脏损伤和炎症生物标志物的影响。
检索截至2022年6月5日的Embase、Medline/PubMed、Web of Science、Scopus和Cochrane图书馆。纳入所有检测接受褪黑素治疗的CABG患者心脏损伤和炎症生物标志物的随机对照试验。采用随机效应模型进行分析。
通过数据库检索共获得947条引文。最终，筛选后纳入5篇文章（6项试验，342例患者）。补充褪黑素可使接受CABG手术患者的心肌肌钙蛋白I（CTnI）[加权平均差（WMD）：-2.28 ng/ml；95%可信区间-2.87，-1.69；P<0.01；I：91.25%]和高敏C反应蛋白（hs-CRP）水平显著降低（WMD：-0.62 mg/L；95%可信区间-0.73，-0.5；P<0.01；I：99.98%）。我们发现补充褪黑素后肌酸激酶同工酶肌肉/脑（CK-MB）水平无显著降低（WMD：-2.87 ng/ml；95%可信区间-5.97，0.23；P = 0.07；I：99.98%）。根据Egger检验未发现发表偏倚。
补充褪黑素可能有助于降低CABG候选患者的心脏损伤和炎症生物标志物水平。未来的研究应探讨这些发现的临床意义。
