High-dose cimetidine reduces proinflammatory reaction after cardiac surgery with cardiopulmonary bypass.

Author(s): Tayama E, Hayashida N, Fukunaga S, Tayama K, Takaseya T, Hiratsuka R, Aoyagi S

Affiliation(s): Department of Surgery, Kurume University School of Medicine, Kurume-city, Japan. eiki@med.kurume-u.ac.jp

Publication date & source: 2001-12, Ann Thorac Surg., 72(6):1945-9.

Publication type: Clinical Trial; Randomized Controlled Trial

BACKGROUND: Cimetidine, which is usually used for gastric ulcer, enhances cellular immunity. The effect of cimetidine on perioperative proinflammatory response after cardiac surgery with cardiopulmonary bypass was investigated. METHODS: Elective coronary artery bypass graft cases in which CPB was performed were placed randomly in a cimetidine (C) group (n = 20) or a no-treatment (N) group (n = 20). The time course of plasma levels of neutrophil elastase, interleukin (IL)-6 and IL-8, leukocyte counts, lymphocyte recovery ratio, C-reactive protein, creatine-kinase-MB, and oxygenation index were analyzed. RESULTS: The plasma levels of neutrophil elastase and IL-8 were inhibited in the C groups at 2 hours after CPB termination. In a comparison of the two groups, the C group demonstrated higher lymphocyte recovery ratio and lower C-reactive protein on postoperative day 5 and shorter intubation time. No intergroup differences were observed in IL-6, leukocyte counts, creatine-kinase-MB levels, or oxygenation index. CONCLUSIONS: Cimetidine may reduce surgical stress and augment the immune system after cardiac surgery with cardiopulmonary bypass.