Prostaglandin E2, Prostacyclin, and Thromboxane Changes During Nonpulsatile Cardiopulmonary Bypass in Humans

Faymonville, Marie-Élisabeth; Deby‐Dupont, G.; Larbuisson, Robert; Deby, C.; Bodson, Lucien; Limet, Raymond; Lamy, Maurice

doi:10.1097/00132586-198708000-00005

Cited by 10 publications

(12 citation statements)

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“…Intravenous study It is believed that the contact between blood and synthetic surfaces in the extra-corporeal circuit activates platelets, endothelial cells and leucocytes with resultant thrombotic tendency [60] [61]. Furthermore, the cardiopulmonary bypass increases prostacyclin and thromboxane levels [62,63] In addition, cross clamping may contribute to ischaemicreperfusion insults to the myocardium [64]. The combination of these factors, which may be exponential, explain why CABG patients are more susceptible to the CV complications of valdecoxib.…”

Section: Regulatory Affairsmentioning

confidence: 99%

Valdecoxib: the rise and fall of a COX-2 inhibitor

Atukorala

Hunter²

2013

Expert Opinion on Pharmacotherapy

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Introduction: Valdecoxib is a cyclooxygenase 2 (COX-2) selective anti -inflammatory drug. It is associated with a reduced incidence of gastrointestinal complications and is potentially useful for patients with rheumatological diseases requiring longer term anti-inflammatory treatment.Areas covered: Due to a perceived increased risk of thrombotic events, particularly cardiovascular hazards and reports of unpredictable, potentially life threatening skin reactions, valdecoxib has been voluntarily withdrawn from the market since 2005. This review manuscript examines the therapeutic potential and the adverse events of valdecoxib utilising a pubmed and web of sciences search to select literature on this subject.Expert opinion: Whilst valdecoxib did have reduced incidence of gastrointestinal complications due to a perceived increased risk of thrombotic events it was withdrawn. The limitations of the research supporting the withdrawal of this potential are discussed.

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Section: Regulatory Affairsmentioning

confidence: 99%

Valdecoxib: the rise and fall of a COX-2 inhibitor

Atukorala

Hunter²

2013

Expert Opinion on Pharmacotherapy

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“…Several stress-induced humoral mediators are increased after CPB, e. g. cortisol [16,17], prostaglandins (e. g. PGE 2 ) [18], soluble cytokine receptors [6] and anti-inflammatory cytokines [4]. All these factors may contribute to the total cytokineinhibitory capacity in patient sera.…”

Section: Discussionmentioning

confidence: 99%

Regulation of cytokine synthesis in cardiac surgery: Role of extracorporeal circuit and humoral mediators in vivo and in vitro

et al. 2007

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“…Each of these fi nal products may cause vicious cycles of infl ammatory activation and coagulation alterations. 13,14 The ability to inhibit these undesired effects will help to control the deleterious effects of CPB. Prior attempts have been made with the use of steroids or a thromboxane synthetase inhibitor.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Prevention of the Deleterious Effects of Cardiopulmonary Bypass

Hassantash

Omrani²,

Givtaj³

et al. 2007

Asian Cardiovasc Thorac Ann

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Indomethacin is a known immune modulator that inhibits cyclooxygenase. Studies indicate that ketoconazole, a selective lipoxygenase and thromboxane A(2) synthetase inhibitor, can prevent activation of the inflammatory cascade by inhibition of proinflammatory mediators. This study was designed to determine if ketoconazole or indomethacin could reduce the adverse effects of extracorporeal circulation. As a double-blind prospective study, 76 patients were randomized into 3 groups according to preoperative medication: indomethacin, ketoconazole, and placebo groups, with 25, 26, and 25 patients, respectively. Four types of parameters were evaluated preoperatively and up to 24 hr after cardiac surgery in all patients: inflammatory (complement C3 and C4, C-reactive protein, immunoglobulins); hematologic; coagulation; and physiologic (blood loss, fluid and blood components received, weight gain, and duration of ventilation). Statistical analyses showed similar patient profiles in each group. Complement C4 decreased in all groups postoperatively, but significantly less in the indomethacin group ( p < 0.01). Ketoconazole reduced postoperative bleeding ( p < 0.0001) as well as the incidence of re-operation for bleeding ( p = 0.05). It was concluded that indomethacin decreases complement (specifically C4) consumption during cardiopulmonary bypass, and ketoconazole may reduce postoperative bleeding by limiting coagulation abnormalities in cardiac surgery patients.

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Prostaglandin E2, Prostacyclin, and Thromboxane Changes During Nonpulsatile Cardiopulmonary Bypass in Humans

Cited by 10 publications

References 0 publications

Valdecoxib: the rise and fall of a COX-2 inhibitor

Valdecoxib: the rise and fall of a COX-2 inhibitor

Regulation of cytokine synthesis in cardiac surgery: Role of extracorporeal circuit and humoral mediators in vivo and in vitro

Pharmacological Prevention of the Deleterious Effects of Cardiopulmonary Bypass

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