Cardiopulmonary Bypass Clinical Trial
Official title:
Double-Blind Phase II Pilot Monocentric Randomized Clinical Trial Evaluating the Effect of a Preliminary Administration of Cyclosporine on Different Markers of Cardiac Ischemia Led by the Aortic Cross-clamp During Coronary Artery Bypass Surgery With Cardiopulmonary Bypass.
Observe the effect of preliminary cyclosporine administration on different markers of cardiac ischaemia led by the aortic cross-clamp during coronary artery bypass surgery with Cardiopulmonary bypass.
The coronary artery bypass surgery, in spite of substantial improvements during the last
years, is still associated to a post-operative mortality and morbidity: myocardial
infarction, heart failure, cardiac arrhythmia, renal failure, Stroke.
These complications are often due to ischaemia - reperfusion injury event. Recent studies
showed that in case of cellular stress (in particular during the reperfusion after
ischaemia) a not specific pore, called Mitochondrial permeability transition Pore (MPTP),
could be opened. That caused the loss of ion homeostasis, then cell death as well as by
apoptosis as by necrosis.
Prevent the opening of this MPTP during the myocardial reperfusion after coronary bypass,
for example, is an important objective to improve the cardioprotection.
The Cyclosporin A, prevents the MPTP from opening. Several studies have shown an
cytoprotection led by cyclosporin A, after ischaemia reperfusion in several models as
isolated rats heart, in vivo rats heart and ex vivo myocardial ( atrial ) human tissues.
Recently, a multicentric study performed in humans, during the acute phase of myocardial
infarction, showed a reduction of infarct size by approximately 40% in the cyclosporine
group compared to control group.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
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