Boldt et al. (7) | Adm. of enalaprilat after anesthesia in CABG candidates, continuous intravenous infusion of enalaprilat (0.6 micg/kg/min) | Markers of ischemic myocardial tissue damage (CKMB, TnT, and GPBB) increased significantly less than control group. Changes in the ST segment indicating ischemia were least common in the enalaprilat group. | Continuous infusion of ACE inhibitors before cardio-pulmonary bypass may help to protect the heart against ischemia/reperfusion injury. |
Leesar et al. (8) | Receive a 10-min intracoronary infusion of bradykinin (2.5 mg/min) or normal saline just 10 min before PTCA(three times of 2 min balloon inflations 5 min apart) | In bradykinin-treated patients, the ST-segment shift during the first inflation was significantly smaller than in the control group, and there were no appreciable differences in ST-segment shift during the three inflations. | Infusion of bradykinin had no hemodynamic effects and no significant adverse effects, and it could protect the myocardium against the ischemia. |
Walter et al. (9) | Adm. of 7.5 mg/d enalapril on first day and 20 mg/d on the other 6 days (mean) before the CABG | No significant differences between enalapril and control group concerning CK, CK-MB, LDH, TnT, TAT, fibrinogen, and kallikrein like activity. | ACE inhibition before CABG is feasible without activation of contact phase. It has no effect on the time course of thrombin activation. Reduction of ischemic injury during CPB is not achieved by enalapril. |
Wei et al. (10) | Total dose of 25μg of BK infusion for 7 min prior to cardiopulmonary bypass | Acute decrease of blood pressure, minimum MAP was 72.7% of the original MAP. No difference in baseline levels of cTnI and CK-MB between case and control group. BK group released less CK-MB.(lower maximum CK-MB). | Exogenous bradykinin is weak cardioprotective agent in low-risk patients. This dose cause acute reduction in BP. |
Leesar et al. (11) | Intracoronary enalaprilat or normal saline before PTCA. Enalaprilat (0.75 mg in 50 mL saline) was infused over 15 min at 0.05 mg/min directly into the stenotic artery (total dose 0.75 mg) | Greater ST-segment shift in control group during the first inflation than during the second and third inflations. Enalaprilat-pretreated patients showed no change in ST-segment shift during inflations. Smaller chest pain score in enalaprilat group. | Pretreatment with enalaprilat attenuates the manifestations of myocardial ischemia during angioplasty. |
Ungi et al. (12) | Two 120-second coronary artery occlusions separated by a reperfusion interval of 10 min. Intracoronary infusion of enalaprilat (50 μg/min) between inflations | No significant differences in ST-segment elevation between two inflations in control group. Less pronounced and slower ST-segment elevation before second inflation than the first one in enalaprilat group. | Adm. of enalaprilat during PCI provides protection to patients who do not have a protective response to the initial balloon inflation. |
Wang et al. (13) | Infusion of 25 μg BK via central venous port of a Swan-Ganz catheter for 7 min before the CPB | No significant difference in TnI between groups. Patients released significantly less CK-MB than the controls. plasma levels of IL-6, IL-8 and IL-10 increased significantly after reperfusion in both groups as compared with baseline. | Exogenous adm. of BK prior to CPB in CABG patients attenuates ischemic myocardial injury. shifting the circulating inflammatory cytokine balance towards the anti-inflammatory direction. |
Saxena et al. (14) | RIPC by inflation of a blood pressure cuff on the arm | Kinin B2 receptor expression did not differ between the groups at baseline (pre-RIPC), but was significantly lower in the RIPC group than in the control group after RIPC/sham. Down-regulation of both B1 and B2 receptors in RIPC group. No differences in CK, CRP, cytokine, lactate or troponin I levels between the groups. Increase in neutrophil elastase levels. | RIPC down-regulated the expression of kinin B1 and B2 receptors in neutrophils of patients undergoing CABG. |
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