Coronary Artery Disease Clinical Trial
Official title:
Effects of Oral Nitrate During Coronary Artery Bypass Surgery
The purpose of this study is to determine whether oral sodium nitrate administration prior to coronary artery bypass surgery can reduce perioperative levels of troponin T. In addition, plasma and urine surrogate markers of renal, hepatic and brain injury will be monitored.
Nitric oxide (NO) is an important mediator in the cardiovascular system and has been shown
to have protective properties in ischemia-reperfusion injury. Inorganic nitrate, an
oxidation product from endogenous NO production and also a constituent in green leafy
vegetables, can be recycled, via nitrite, back to bioactive NO in the body. Recent research
has shown beneficial effects of nitrate and nitrite in animal models of myocardial
ischemia-reperfusion injury. Moreover, dietary nitrate reduces blood pressure and oxygen
cost during exercise in humans.
During coronary bypass surgery the heart undergoes ischemia-reperfusion injury and troponin
T is most often released from the myocardium. The aim of the present study is to investigate
if preoperative inorganic nitrate, in doses easily achievable from the diet, can affect
troponin T release as well as other surrogate markers of injury to the liver, kidneys and
the brain. In addition, plasma and urine samples will be collected for markers of oxidative
stress and inflammation (sCRP and cytokines). Patients planned for bypass surgery who give
their written informed consent will, the night before surgery, get a standardized,
low-nitrate meal where after they receive sodium nitrate on two occasions preoperatively;
the night before and in the morning before surgery. Plasma and urine samples will be
collected at various time points up to 72 hours after surgery.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Basic Science
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