Can clonidine, enoximone, and enalaprilat help to protect the myocardium against ischaemia in cardiac surgery?
OBJECTIVE: To evaluate whether clonidine, enoximone, and enalaprilat reduce ischaemia-related myocardial cell damage in cardiac surgery. DESIGN: Prospective randomised controlled trial. SETTING: Clinical investigation in a cardiac anaesthesia department of a university hospital. PATIENTS: 88 consecutive patients undergoing coronary artery bypass surgery. INTERVENTIONS: After induction of anaesthesia patients continuously received the alpha 2 agonist clonidine (group 1, n = 22), the phosphodiesterase (PDE) III inhibitor enoximone (group 2, n = 22), the angiotensin converting enzyme (ACE) inhibitor enalaprilat (group 3, n = 22), or saline solution as placebo (control group, n = 22). The infusion was stopped immediately before the start of cardiopulmonary bypass. MAIN OUTCOME MEASURES: The ST segment was analysed and the activity of creatine kinase isoenzyme MB (CKMB), cardiac troponin T (TnT), and the BB isoenzyme of glycogen phosphorylase (GPBB) were measured before the start of infusio
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