Chris A. Rogers, PhD, Alan J

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Presentation transcript:

Propofol cardioplegia: A single-center, placebo-controlled, randomized controlled trial Chris A. Rogers, PhD, Alan J. Bryan, DM, FRCS (CTh), Rachel Nash, MSc, M. Saadeh Suleiman, PhD, DSc, Sarah Baos, PhD, Zoe Plummer, MSc, PhD, James Hillier, MA, MBBS, FRCA, Ian Davies, MB, BCh(Wales), FRCA, Dip ABA, Richard Downes, ACP, Eamonn Nicholson, ACP, Barnaby C. Reeves, DPhil, MSc, MA, Gianni D. Angelini, MD, MCh, FRCS, FETCS The Journal of Thoracic and Cardiovascular Surgery Volume 150, Issue 6, Pages 1610-1619.e13 (December 2015) DOI: 10.1016/j.jtcvs.2015.06.044 Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Participant flow. CABG, Coronary artery bypass grafting; AVR, aortic valve replacement; CPB, cardiopulmonary bypass; LV, left ventricular; PIL, Patient Information Leaflet. *Patients may be ineligible for >1 reason. †Safety population identical to analysis population. ‡Two participants (1 randomized to propofol, 1 to intralipid) were withdrawn before surgery, but willing to continue with trial data collection. Both were found to be ineligible after randomization. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1610-1619.e13DOI: (10.1016/j.jtcvs.2015.06.044) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Cardiac troponin T response over time. Geometric mean and 95% confidence interval (CI) of cardiac troponin T level at each time point and geometric mean ratio (GMR) for the effect of propofol versus intralipid on cardiac troponin T release (95% CI). Pre-op, Preoperative; Post-op, postoperative. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1610-1619.e13DOI: (10.1016/j.jtcvs.2015.06.044) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Concentrations over time. A, Lactate (all participants). B, pH Levels (all participants), C, Creatinine (coronary artery bypass grafting [CABG] participants). D, Creatinine (aortic valve replacement [AVR] participants). Geometric mean and 95% confidence interval (CI) at each study time point by group, and geometric mean ratio (GMR) and 95% CI for the effect of propofol versus intralipid on lactate (all participants), creatinine (CABG participants), and creatinine (AVR participants). Mean and standard deviation (SD) at each study time point by group, and mean difference (MD) and 95% CI for the effect of propofol versus intralipid on pH level (all participants). Pre-op, Preoperative; Post-op, postoperative. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1610-1619.e13DOI: (10.1016/j.jtcvs.2015.06.044) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Effect of propofol on cardiac troponin T release by diabetes status. GMR, Geometric mean ratio; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1610-1619.e13DOI: (10.1016/j.jtcvs.2015.06.044) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Effect of propofol on troponin T release: sensitivity analyses. GMR, Geometric mean ratio; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1610-1619.e13DOI: (10.1016/j.jtcvs.2015.06.044) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure E3 Quality of life scores at 3 months. EQ-5D, EQ-5D health questionnaire; VAS, visual analog scale; CROQ, Coronary Revascularisation Outcome Questionnaire; CABG, coronary artery bypass graft; MLHFQ, Minnesota Living with Heart Failure Questionnaire; MD, mean difference; OR, odds ratio; AVR, aortic valve replacement; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1610-1619.e13DOI: (10.1016/j.jtcvs.2015.06.044) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure E4 Effect of propofol on quality-of-life scores: sensitivity analyses. EQ-5D, EQ-5D health questionnaire; VAS, visual analog scale; CROQ, Coronary Revascularisation Outcome Questionnaire; CABG, coronary artery bypass graft; MLHFQ, Minnesota Living with Heart Failure Questionnaire; MD, mean difference; OR, odds ratio; AVR, aortic valve replacement; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1610-1619.e13DOI: (10.1016/j.jtcvs.2015.06.044) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Cardiac troponin T level over time, expressed as geometric mean ratio (GMR) (95% confidence interval) for propofol versus intralipid (placebo). The Journal of Thoracic and Cardiovascular Surgery 2015 150, 1610-1619.e13DOI: (10.1016/j.jtcvs.2015.06.044) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions