Does diltiazem inhibit the inflammatory response in cardiopulmonary bypass?

Med Sci Monit. 2003 Apr;9(4):PI30-6.

Abstract

Background: The objective of our study was to investigate the anti-inflammatory effect and inhibiting action of diltiazem, a calcium channel blocking agent, on the systemic inflammatory response seen after cardiopulmonary bypass (CPB) in humans, in a controlled prospective study.

Material/methods: Two groups of 15 candidates for coronary artery bypass graft were enrolled in the study. In the study group, 1 g/kg/min of diltiazem was infused during cardiopulmonary bypass, while the control group received saline. Interleukin-6 and 10 (IL-6, IL-10) levels were measured from systemic arterial blood at five time points.

Results: The levels of IL-6, a marker of the severity of systemic inflammation, were significantly higher in the control group at the end of CPB and 3 hours later. At the end of CPB, the mean IL-6 level in the control group was significantly higher than in the diltiazem group (p=0.015), and at 3 hours after CPB the difference was even greater (p=0.002). The levels of IL-10, an anti-inflammatory cytokine that limits the effects of pro-inflammatory cytokines, were higher in the control group, but not statistically significant at any time point.

Conclusions: Diltiazem inhibits the release of the pro-inflammatory cytokine IL-6, which is strong evidence for its anti-inflammatory effect. It is clinically important to inhibit the inflammation that takes place during CPB and the inflammation of myocardium encountered after ischemia-reperfusion, since these effect the clinical status of the patient after CPB, as well as myocardial functions.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aspartate Aminotransferases / blood
  • Blood Platelets / drug effects
  • Calcium Channel Blockers / pharmacology*
  • Cardiopulmonary Bypass / adverse effects*
  • Diltiazem / pharmacology*
  • Female
  • Humans
  • Inflammation / prevention & control*
  • Interleukin-10 / blood
  • Interleukin-6 / blood
  • Length of Stay
  • Leukocytes / drug effects
  • Male
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index
  • Time Factors

Substances

  • Calcium Channel Blockers
  • Interleukin-6
  • Interleukin-10
  • Aspartate Aminotransferases
  • Diltiazem