Clinical trial NCT05895331: The Effects of Dexmedetomidine on Thiol/Disulphide Homeostasis in Coronary Bypass Surgery
Official title: The Effects of Dexmedetomidine on Thiol/Disulphide Homeostasis in Coronary Bypass Surgery
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Dexmedetomidine
Oxidative Stress
Keywords: Disulphide
Thiol
Lead sponsor: Ankara Etlik City Hospital
Sponsor class: OTHER_GOV
First posted: 2023-06-08
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients who have undergone coronary bypass surgery using a cardiopulmonary pump

Brief summary: Dexmedetomidine (DEX) is a sedative and anesthetic drug with known antioxidant properties.In this study, it was aimed to investigate the oxidative stress levels in patients undergoing on-pump CABG by measuring the thiol/disulfide levels and to investigate the effects of dexmedetomidine infusion used in Coronary Bypass Surgery on dynamic Thiol/Disulphide Homeostasis.

Detailed description: It is well known that cardiovascular disease is the leading cause of increased morbidity and mortality worldwide. One of the key surgical procedures that patients with coronary artery disease (CAD) are often subjected to is coronary artery bypass grafting (CABG). However, the cardiopulmonary bypass (CPB) pump increases systemic oxidative stress . High levels of molecular oxygen enter the body during cardiopulmonary bypass (CPB) and reperfusion, followed by inflammation leading to the formation of free oxygen radicals which causes lipid peroxidation, ultimately resulting in an oxidative attack at the cell and tissue level.

Thiols are organic sulphur derivatives containing Sulfhydryl Residues (-SH) in their active regions. Thiols easily react with oxygen containing free radicals to form disulfides. This is a defence mechanism against oxidative stress.7 An automated analysis quantitatively measuring serum native and total thiol, and disulfides has been recently described as a method to determine dynamic Thiol/Disulfide Homeostasis (TDH).The role of dynamic thioldisulfide homeostasis has been increasingly shown in many diseases. There is a growing number of evidences that an abnormal thiol-disulfide homeostasis may play role in the pathogenesis of a variety of diseases such as cardiovascular disease, malignancies, rheumatoid arthritis, chronic kidney disease, and acquired immunodeficiency syndrome.

Dexmedetomidine (DEX) is a sedative and anesthetic drug with known antioxidant properties.In this study, it was aimed to investigate the oxidative stress levels in patients undergoing on-pump CABG by measuring the thiol/disulfide levels and to investigate the effects of dexmedetomidine infusion used in Coronary Bypass Surgery on dynamic Thiol/Disulphide Homeostasis.

Eligibility criteria: Inclusion Criteria:

* Patients who have undergone coronary bypass surgery using a cardiopulmonary pump
* Patients who agreed to participate in the study

Exclusion Criteria:

* Bypass surgeries without cardiopulmonary pump
* Patients with intraoperative unexpected/undesirable complications
* Patients who did not agree to participate in the study
* Patients with missing data

Primary outcomes:
measure: Thiol/Disulphide Homeostasis
timeFrame: 30 min before the start of surgery
measure: Thiol/Disulphide Homeostasis
timeFrame: at the time of aortic cross clamp off
measure: Thiol/Disulphide Homeostasis
timeFrame: at the time of surgery over
Secondary outcomes:
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Ankara Etlik City Hospital
state: Varlık Mahallesi, Halil Sezai Erkut Caddesi Yenimahalle
Study officials:
References:
citation: Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014 Dec;47(18):326-32. doi: 10.1016/j.clinbiochem.2014.09.026. Epub 2014 Oct 7.
citation: Akkus O, Kaypakli O, Koca H, Topuz M, Kaplan M, Baykan AO, Samsa MZ, Quisi A, Erel O, Neselioglu S, Gur M. Thiol/disulphide homeostasis in thoracic aortic aneurysm and acute aortic syndrome. Biomark Med. 2018 Apr;12(4):349-358. doi: 10.2217/bmm-2017-0372. Epub 2018 Feb 13.
citation: Vukicevic P, Klisic A, Neskovic V, Babic L, Mikic A, Bogavac-Stanojevic N, Matkovic M, Milicevic V, Aleksic N, Kotur-Stevuljevic J. Oxidative Stress in Patients before and after On-Pump and Off-Pump Coronary Artery Bypass Grafting: Relationship with Syntax Score. Oxid Med Cell Longev. 2021 Jul 30;2021:3315951. doi: 10.1155/2021/3315951. eCollection 2021.
citation: Unchiti K, Leurcharusmee P, Samerchua A, Pipanmekaporn T, Chattipakorn N, Chattipakorn SC. The potential role of dexmedetomidine on neuroprotection and its possible mechanisms: Evidence from in vitro and in vivo studies. Eur J Neurosci. 2021 Nov;54(9):7006-7047. doi: 10.1111/ejn.15474. Epub 2021 Oct 25.