Effectivity of dexamethasone in patients undergoing off-pump coronary artery bypass surgery

Based on our previous pilot study, systemic inflammatory response syndrome is more common in off-pump compared to on-pump coronary artery bypass. Therefore, we conducted a clinical trial of dexamethasone in patients undergoing off-pump coronary artery bypass. Sixty consecutive patients undergoing of...

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Bibliographic Details
Published in:Asian cardiovascular & thoracic annals 2021-06, Vol.29 (5), p.388-393
Main Authors: Hanafy, Dudy Arman, Harta, I Komang Adhi Parama, Prasetya, I Made Indra, Busroh, Pribadi Wiranda, Soetisna, Tri Wisesa, Sugisman, Wartono, Dicky Aligheri, Tjubandi, Amin, Herlambang, Bagus
Format: Article
Language:English
Subjects:
Coronary Artery Bypass, Off-Pump
Dexamethasone
Humans
Length of Stay
Pilot Projects
Postoperative Complications - etiology
Treatment Outcome
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Summary:Based on our previous pilot study, systemic inflammatory response syndrome is more common in off-pump compared to on-pump coronary artery bypass. Therefore, we conducted a clinical trial of dexamethasone in patients undergoing off-pump coronary artery bypass. Sixty consecutive patients undergoing off-pump coronary artery bypass were enrolled from August 2018 to January 2019 and randomized to a dexamethasone or placebo group of 30 each. Clinical outcomes were analyzed. There was a lower incidence of major adverse cardiac events in the dexamethasone group compared to the placebo group (17% versus 43%,  = 0.024). Clinical outcomes in the dexamethasone group were better than those in the placebo group, in terms of duration of mechanical ventilation (  = 0.029), intensive care unit stay (  = 0.028), hospital stay (  = 0.04), and vasoactive-inotropic score (  = 0.045). There were significant differences in inflammatory markers between the two groups: interleukin-6 (  = 0.0001), procalcitonin (  = 0.0001), and C-reactive protein (  = 0.0001) were lower in the dexamethasone group. There was a significant association between the incidence of major adverse cardiac events and both interleukin-6 (  = 0.005) and procalcitonin (  = 0.007). Preoperative dexamethasone in patients undergoing off-pump coronary artery bypass is effective in improving clinical outcomes and controlling the postoperative inflammatory reaction.
ISSN:0218-4923
1816-5370
DOI:10.1177/0218492320977648