Abstract
Objectives
Coronary artery bypass graft (CABG) surgery has been reported to be associated with lower postoperative plasma antioxidant and zinc levels. We hypothesized that perioperative supplementation of vitamin E and zinc might improve short-term postoperative outcomes.
Methods
In this placebo-controlled double-blind, randomized study, patients undergoing CABG performed with cardiopulmonary bypass were recruited. The intervention group received zinc and vitamin E supplementation (1200 IU vitamin E and 120 mg elemental zinc) the day before surgery, followed by postoperative daily supplementation of 30 mg zinc and 200 IU vitamin E from the 2nd day after surgery to 3 weeks. The control group received placebos. Length of stay (LOS) in the intensive care unit and hospital, sequential organ failure assessment score on 3rd day after surgery, and plasma inflammatory markers on days 3 and 21 post-surgery were evaluated.
Results
Seventy-eight patients completed the study (40 in the intervention group and 38 in the placebo group). The hospital LOS was significantly shorter (p < 0.05) in the intervention group. Postoperative changes in plasma albumin levels were not different between the two groups. The plasma zinc level was higher (p < 0.0001), but plasma C-reactive protein (p = 0.01), pentraxin 3 (p < 0.0001), interferon γ (p < 0.05), malondialdehyde (p < 0.05), and aspartate aminotransferase (p < 0.01) were lower in the intervention group compared to the placebo group.
Conclusions
Perioperative vitamin E and zinc supplementation significantly reduced hospital LOS and the inflammatory response in CABG surgery patients. In these patients, the optimal combination and dose of micronutrients need further study but could include zinc and vitamin E.
Clinical trial registry
This trial was registered at ClinicalTrials.gov website (NCT05402826).
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Data availability
The data of this study are available from the corresponding author upon reasonable request.
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Acknowledgements
The authors would like to thank the staff of the Cardiac Intensive Care Unit of Shafa Hospital.
Funding
This work was supported by a research grant from Shahid Beheshti University of Medical Sciences.
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The research was conceived by JN, designed by JN, EM, and RN; conducted by EM and RN, and MS; data were analyzed by JN; the paper was written by EM and JN. All authors approved the final version of the manuscript.
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Makiabadi, E., Nakhaeizadeh, R., Soleimani, M. et al. Effects of perioperative vitamin E and zinc co-supplementation on systemic inflammation and length of stay following coronary artery bypass graft surgery: a randomized controlled trial. Eur J Clin Nutr 78, 120–127 (2024). https://doi.org/10.1038/s41430-023-01356-x
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DOI: https://doi.org/10.1038/s41430-023-01356-x