Amirizadeh Mehran, Eslami Gohar, Shafaei-Bajestani Negar, Soleimani Aria, Habtemariam Solomon, Hashemi Javad, Sahebnasagh Adeleh
Department of Pharmacotherapy, Faculty of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran.
Department of Clinical Pharmacy, Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
Recent Adv Inflamm Allergy Drug Discov. 2025;19(1):110-117. doi: 10.2174/0127722708282330240522100230.
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.
This clinical trial aimed to investigate the effect of trace elements supplements on postoperative outcomes after coronary artery bypass graft.
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.
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.
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.
冠状动脉旁路移植术（CABG）用于延长冠心病（CAD）患者的寿命。必需元素的血清水平低对接受CABG的患者有负面影响。
本临床试验旨在研究微量元素补充剂对冠状动脉旁路移植术后结局的影响。
200例接受体外循环CABG的患者被随机给予含有必需微量元素的安达美或等渗盐水，持续3天。我们在第0、1和2天测量术后血浆锌、硒、铜、锰、硒和铁的浓度，以及高敏C反应蛋白（hs-CRP）水平。住院时间和重症监护病房（ICU）停留时间、30天死亡率和房颤（AF）发生率已作为次要结局进行评估。
在补充组中，到第3天血浆铜和锰水平升高，两组血浆hs-CRP在第1天均升高，但在第2天接受微量元素补充的患者中有所下降。安达美组死亡率较低，尽管差异未达到显著水平。观察到血浆锌水平与30天死亡率之间存在显著负相关，术前血浆CRP水平与脓毒症相关器官功能衰竭评估（SOFA）评分之间也存在另一个显著负相关。干预组和安慰剂组之间的其他测量参数相似。
接受CABG的患者似乎从微量元素补充中获益。CABG后短期给予安达美可防止微量元素血清浓度下降，并降低循环血浆CRP水平。
