Jalili Shahandashti Farshad, Mozayan Mohammadhadi, Abdolkarimi Leyla, Kargar Faranak, Ghanbari Amene, Heidarinia Saeid, Totonchi Ghorbani Mohammad Ziae, Nabavi Seyed Salaheddin, Hosseini Zargaz Seyyed Ebrahim
Rajaie Cardiovascular Medical and Research Institute, Shaheed Rajaie Cardiovascular Medical and Research Institute, Tehran, Islamic Republic of Iran.
Department of General Surgery, School of Medicine, Imam Khomeini Hospital, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Islamic Republic of Iran.
Egypt Heart J. 2025 Jul 17;77(1):72. doi: 10.1186/s43044-025-00641-3.
A main concern during cardiac surgery is the protection of the heart. Myocardial ischemia tends to increase the generation of reactive oxygen species. Based on its oxidation-reduction potentials, vitamin C is the most powerful antioxidant to counteract the effects of free radicals. This reason made the researcher to perform this study with the goal to determine and evaluate the effect of on perioperative clinical outcomes and laboratory criteria of coronary artery bypass grafting (CABG) cases.
This randomized clinical trial (RCT) was done in 2022 at Rajaie Cardiovascular Medical and Research Center. Following obtaining permission from the ethics committee, 62 CABG patients were randomly allocated to two groups and were included in the study. The control group received routine Del Nido cardioplegia solution while vitamin C group received Del Nido cardioplegia solution containing 3gr of vitamin C. In this study, demographic information and variants like hemodynamic, blood, and FFP transfusion were evaluated and compared. Data were analyzed by two-way repeated measures ANOVA.
According to the findings, diastolic blood pressure (DBP) in the vitamin C group was lower, which was significant across both groups (P < 0.05); however, these alterations were in the normal range. The groups showed no significant difference in other parameters like fresh frozen plasma (FFP) transfusion in the intensive care unit (ICU) and return to baseline heart rate (P > 0.05). Also, the average cardiac arrest time (average time to cardiac arrest from the time of cardioplegia injection) in the controls was significantly higher compared to the intervention group (P = 0.028).The data indicate that for CK-MB, the group effect is not statistically significant, while the effect of time and the interaction effect of group and time are significant. For troponin, the group effect and the interaction effect are not significant, although the effect of time is significant. Therefore, adding vitamin C to the cardioplegia solution does not significantly affect troponin.
One of the factors that contribute to myocardial protection is the reduction in the time to achieve cardiac arrest. In the group that received vitamin C, this time was reduced; therefore, it can be concluded that in this group, the risk of damage due to lack of blood flow and oxygen to the cardiac tissue is lower.
This study is a randomized clinical trial (RCT).
IRCT20220716055477N1.
心脏手术期间的一个主要关注点是心脏保护。心肌缺血往往会增加活性氧的产生。基于其氧化还原电位，维生素C是对抗自由基影响的最强大抗氧化剂。出于这个原因，研究人员开展了本研究，目的是确定和评估其对冠状动脉旁路移植术（CABG）病例围手术期临床结局和实验室指标的影响。
这项随机临床试验（RCT）于2022年在拉贾伊心血管医学和研究中心进行。在获得伦理委员会许可后，62例CABG患者被随机分为两组并纳入研究。对照组接受常规的德尔尼多心脏停搏液，而维生素C组接受含有3克维生素C的德尔尼多心脏停搏液。在本研究中，对人口统计学信息以及血流动力学、血液和新鲜冰冻血浆输注等变量进行了评估和比较。数据采用双向重复测量方差分析进行分析。
根据研究结果，维生素C组的舒张压（DBP）较低，两组间差异具有统计学意义（P < 0.05）；然而，这些变化处于正常范围内。两组在其他参数上无显著差异，如重症监护病房（ICU）的新鲜冰冻血浆（FFP）输注量和心率恢复至基线水平（P > 0.05）。此外，对照组的平均心脏停搏时间（从注射心脏停搏液到心脏停搏的平均时间）显著高于干预组（P = 0.028）。数据表明，对于肌酸激酶同工酶（CK - MB），组间效应无统计学意义，而时间效应以及组间与时间的交互效应具有统计学意义。对于肌钙蛋白，组间效应和交互效应无统计学意义，尽管时间效应具有统计学意义。因此，在心脏停搏液中添加维生素C对肌钙蛋白无显著影响。
有助于心肌保护的因素之一是缩短达到心脏停搏的时间。在接受维生素C的组中，这一时间缩短了；因此，可以得出结论，在该组中，心脏组织因血流和氧气缺乏而受损的风险较低。
本研究是一项随机临床试验（RCT）。
IRCT20220716055477N1。
