Effect of Selenium on Ischemia-Reperfusion Injury in the Coronary Artery Bypass Graft Surgery: A Clinical Trial Study

Sedighinejad, Abbas; Imantalab, Vali; Mirmansouri, Ali; Jouryabi, Ali Mohammadzadeh; Sheikhani, Nassir Nassiri; Nabi, Bahram Naderi; Haghighi, Mohammad; Biazar, Gelareh; Atrkarroushan, Zahra

doi:10.5812/ircmj.42562

Cited by 4 publications

(8 citation statements)

References 45 publications

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“…Nevertheless, these differences did not show a statistically significant threshold. According to our results, selenium administration via cardioplegia solution did not effectively reduce CK-MB level in the patients undergoing CABG, which agreed with the findings of Sedighinejad et al (20).…”

Section: Discussionsupporting

confidence: 92%

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Effect of Selenium Added to the Cardioplegic Solution on Cardiac Protection in Coronary Artery Bypass Grafting Surgeries: A Randomized, Double-Blinded, Clinical Trial Study

MasihShafa

Azemati

MasoodAbasi

et al. 2019

Iran Red Crescent Med J

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Background: Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) triggers an inflammatory reaction, leading to the development of myocardial damage and dysfunction. Selenium is the main cofactor for many antioxidant enzymes. Selenium level is decreased during heart surgeries affecting the cardiopulmonary pump, which in turn can aggravate the organ and heart dysfunction and mortality. Objectives: The aim of this study was to evaluate the cardiac protective effects of adding selenium to cardioplegia solution in these surgeries. Methods: In this randomized, double-blind, clinical trial study that was conducted in the department of cardiac surgery of Shiraz University of Medical Sciences (SUMS) in Shiraz, Iran, 67 elected CABG patients were allocated to the two control or selenium groups.In the intervention group, 1000 µg sodium selenite was added to cardioplegia solution. The same amount of normal saline was added to the cardioplegia solution in the control group. Arterial blood samples were withdrawn before anesthesia induction (T1), immediately after the surgery (T2), as well as, 6 and 24 hours after the surgery (T3 and T4 respectively), to determine the CK-MB and Troponin I levels.Results: According to our findings, the CK-MB and Troponin I cardiac enzyme levels were significantly different, considering different time points (P < 0.05). Despite lower enzyme levels in the selenium group, the differences were not statistically significant between the two groups (P > 0.05). There were also no significant differences between the two groups regarding systolic and diastolic blood pressures. Conclusions:The administration of 1000 µg sodium selenite via cardioplegia solution had no significant cardioprotective effect during coronary bypass surgery in CABG patients.

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Section: Discussionsupporting

confidence: 92%

“…T2), the differences were not statistically significant. However, this observation was opposed to the finding of Sedighinejad et al (20) at 6 hours postoperation (i.e. T2).…”

Section: Discussioncontrasting

confidence: 78%

Effect of Selenium Added to the Cardioplegic Solution on Cardiac Protection in Coronary Artery Bypass Grafting Surgeries: A Randomized, Double-Blinded, Clinical Trial Study

MasihShafa

Azemati

MasoodAbasi

et al. 2019

Iran Red Crescent Med J

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“…The protective effects of selenium during oxidative stress have been shown (8)(9)(10)(11)(12). In some experimental studies, selenium supplementation could decrease postoperative complications after cardiac surgery and affected the stress oxidative process (9,13).…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Selenium Trace and Patient Outcome After Open-Heart Surgery

et al. 2020

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Background: Acute stress response to heart surgery can cause major morbidity in patients. The trace of selenium is useful for preventing heart damage. Although the trend of selenium changes is of high importance for body balance, the usefulness of routine use and effectiveness of this element for patients under open-heart surgery is still unclear. Objectives: This study aimed at assessing serum selenium level before and after open-heart surgery and the relationship between selenium trace and patient outcome. Methods: This prospective analytical study was performed on 100 patients undergoing open-heart surgery using cardiopulmonary bypass (CPB). In all patients, the serum level was measured at a predetermined time (before surgery and one and two days after surgery). Then, the relationship between serum selenium and patient outcome was assessed. Results: The mean serum selenium level in patients on admission was 72.90 ± 14.62 μg/L, one day after surgery was 71.20 ± 15.84 μg/L, and two days after surgery was 71.54 ± 15.97 μg/L. Serum selenium levels were inversely and significantly associated with age (r = -0.183; P = 0.034, 013) duration of surgery (r = -221 and P = 0.014), duration of intensive care unit stay (r = 0.204, P = 0.021), and duration of CPB (r = 0.223, P = 013). Conclusions: Based on this study’s results, a low level of selenium can affect patients’ outcomes after open-heart surgery.

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“…The majority of the included studies reported an overall low risk of bias, enhancing the authenticity of this meta analysis. Out of the 7 included studies, 3 studies reported detection bias which was the only main factor that hindered the quality of included studies ( 18 , 21 , 22 ). Additionally, the trial conducted by Amini et al reported performance bias ( 18 ).…”

Section: Resultsmentioning

confidence: 99%

“…Four of seven RCTs ( 16 , 17 , 21 , 22 ) compared data on the post-operative CK-MB levels between selenium-supplemented and control group patients. A marginal difference was found in the postoperative CK-MB levels between the two groups (WMD = 0.73; 95% CI = −6.80–8.26; P = 0.85; I 2 = 95%).…”

Section: Resultsmentioning

confidence: 99%

Perioperative selenium administration in cardiac surgery patients, a way out to reduce post surgical adversities? A meta analysis

Rehan,

Hussain,

Imran

et al. 2023

Front. Cardiovasc. Med.

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IntroductionThe oxidative damage suffered in cardiac surgery is associated with declining trace elements which lead to the development of multi organ dysfunction (MOD), acute kidney injury (AKI), or increased length of hospital stay (LOS). Recent evidence shows the cardioprotective role of the trace element selenium as it mitigates worsening outcomes post cardiac surgery. Hence, this meta analysis aims to investigate the role of selenium in lowering cardiac surgery related adverse outcomes.MethodsLiterature search of five electronic databases was performed from the inception of the paper till 29th July, 2023. Eligibility criteria included; (a) randomized clinical trials with Adult patients (≥18 years) undergoing cardiac surgery (b) intervention with selenium pre or/and postoperatively; (c) a control group of a placebo, normal saline, or no selenium. Outcomes of interest include postoperative mortality, LOS in the hospital and Intensive Care Unit (ICU), AKI, troponin I, and Creatinine Kinase-MB (CK-MB). The Cochrane bias assessment tool was used to evaluate the risk of bias. Outcomes were pooled with the Mantel-Haenszel Random-effects model using Review Manager.ResultsSeven RCTs with 2,521 patients and 65% of males were included in this paper. No noticable differences were observed between selenium and control groups in terms of postoperative AKI, mortality, LOS in hospital and ICU, troponin I, and CK-MB levels. All studies had a low risk of bias on quality assessment.DiscussionOur meta analysis demonstrated no discernible effects of selenium infusion on post operative complications among patients undergoing cardiac surgery. Further large scale multi centered studies comparing the protective role of selenium with combined therapy of other bioactive agents are needed to provide convincing explanations.Systematic Review RegistrationPROSPERO Identifier: 424920.

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Effect of Selenium on Ischemia-Reperfusion Injury in the Coronary Artery Bypass Graft Surgery: A Clinical Trial Study

Cited by 4 publications

References 45 publications

Effect of Selenium Added to the Cardioplegic Solution on Cardiac Protection in Coronary Artery Bypass Grafting Surgeries: A Randomized, Double-Blinded, Clinical Trial Study

Effect of Selenium Added to the Cardioplegic Solution on Cardiac Protection in Coronary Artery Bypass Grafting Surgeries: A Randomized, Double-Blinded, Clinical Trial Study

Relationship Between Selenium Trace and Patient Outcome After Open-Heart Surgery

Perioperative selenium administration in cardiac surgery patients, a way out to reduce post surgical adversities? A meta analysis

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