The Effect of Circadian Melatonin Levels on Inflammation and Neurocognitive Functions Following Coronary Bypass Surgery

Abstract

Purpose: In this study, the relationship between the plasma levels of melatonin and intercellular adhesion molecule-1 (ICAM-1), which plays role in several intercellular interactions including inflammatory and immune responses, and early neurocognitive functions associated with ischaemia-reperfusion injury during open heart surgery is examined. Methods: Forty patients who were to undergo elective coronary artery bypass grafting (CABG) were divided into two groups, those who underwent their operations at 8 AM (group I; n = 20) and those who underwent their operations at 1 PM (group II; n = 20). Blood samples were collected prior to surgery (S1), when the aortic cross clamp was removed (S2) and 4 (S3) and 24 h after the surgery (S4). Neuropsychiatric assessment was conducted one day before and seven days after surgery. Results: Melatonin levels measured during and after surgery were also significantly higher in Group 1. ICAM-1 levels were significantly lower in Group 1 at S2 and S3. Significant deterioration was observed in postoperative neurocognitive function compared with preoperative functions in Group 2 more than Group 1. Conclusion: We hypothesise that the greater preservation of neurocognitive functions in the morning patients is associated with elevated melatonin levels, which reduce the damage from ischaemia-reperfusion injury.

The effect of surgery started at different time point during the day on the clinical outcomes of mitral valve surgery

“…Moreover, for patients with myocardial infarction, compared to daytime intervention, nighttime coronary intervention therapy has a poor prognosis (13). In addition, whether it is non cardiac surgery (14) or cardiac surgery (15), patients undergoing nighttime surgery are more likely to experience cognitive impairment and sleep disorders after surgery. Based on these evidence, it seems that performing surgery during the day, especially in the morning, is more advantageous.…”

Pre-Surgical Use of Melatonin and Its Significance on Enhancing Prognosis Process in Patients Undergoing Cardiopulmonary Bypass Graft

“…MTN can reduce many undesirable disorders in patients with CABG. These effects are due to the antioxidant, anti-amyloid, and vasodilator effects of MTN 41 . In the study of Haghjooy et al, the effect of pre-CABG Melatonin administration on Nuclear Erythroid2-Related Factor 2 (Nrf2) activation was investigated.…”

Effects of Sleep Quality on Melatonin Levels and Inflammatory Response after Major Abdominal Surgery in an Intensive Care Unit

“…However, Hu et al showed that use of earplugs and eye masks improves sleep quality and nocturnal melatonin levels in a simulated ICU environment [ 20 ]. To our knowledge, the only study on the relation between melatonin secretion and surgical immune response has been conducted on patients who underwent coronary bypass surgery [ 21 ]. In this prospective study, it has been shown that melatonin levels in blood samples taken one hour before and four hours after the surgery, were higher in the group of patients who underwent surgery in the morning compared with the patients who were operated in the afternoon.…”

“…This finding was actually consistent with the normal circadian rhythm of melatonin. Furthermore, authors have shown that, in the group with higher levels of melatonin, plasma ICAM-1 levels, an inflammatory marker, were reduced [ 21 ]. In the present study, preoperative samples were obtained two days before the surgery, which was independent from the timing of the procedure, thus, preoperative melatonin levels were similar in both groups.…”