Melek ÖZTURK, Gülbüz SEZGİN, Kaan KIRALİ, Sabit SARIKAYA, Fuat BÜYÜKBAYRAK, Fatma Kaya DAĞISTANLI, Mete ALP, Eray AKSOY

Does statin pre-treatment affect right atrial myocyte apoptosis in coronary artery bypass graft patients? an in-vivo pilot study

Amaç: Bu çalışmada koroner arter baypas greftleme yapılan hastalarda statin ön tedavisinin sağ atriyal miyositlerin apoptozisine karşı olası koruyucu etkileri araştırıldı.Çalışma planı: Çalışmaya 29 ardışık hasta dahil edildi. Grup 1'deki hastalara (n=12; erkek: 83.3%) hastaneye yatış gününden itibaren atorvastatin 40 mg/gün tedavisi uygulandı, grup 2'deki hastalara (n=17; erkek: 82.3%) ise statin tedavisi uygulanmadı. Sağ atriyal örnekler kardiyopulmoner baypasa girilmeden önce alındı ve %10'luk nötral formalin ile fikse edildi. Apoptotik hücrelerin tespiti için immünoperoksidaz boyama ve TUNEL yöntemi kullanıldı. Immün boyamalı aktif kaspas-3 ve proliferatif hücre nükleer antijen (PCNA) hücrelerinin sayımı ışık mikroskopu kullanılarak yapıldı.Bul gu lar: Grup 1'deki hastaların endokardiyal (p=0.04) ve epikardiyal (p=0.01) katmanlarındaki ortalama apoptotik indeks değerleri grup 2'dekilere kıyasla, anlamlı düzeyde düşük bulundu. Miyokardiyal katmanlardaki değerler arasında fark olmadığı görüldü (p=0.35). Katmanlar arasında ortalama PCNA indeksi açısından anlamlı fark yoktu.So nuç: Koroner arter baypas greftleme öncesi statin ön tedavisinin kardiyak miyosit kaybını azaltabileceği görünmekte olup, açık kalp cerrahisi sonrası yararlı etkilere işaret edebilir.

Koroner arter baypas greft hastalarında statin ön tedavisi sağ atriyal miyosit apoptozisini etkiler mi? In-vivo pilot çalışma

Background: This study aims to investigate the possible protective effects of statin pretreatment against right atrial myocyte apoptosis in patients undergoing coronary artery bypass grafting. Methods: Twenty-nine consecutive patients were included in the study. Group 1 patients (n=12; male: 83.3%) were initiated on atorvastatin 40 mg/day on the day of hospital admission and group 2 patients (n=17; male: 82.3%) did not receive statin therapy. Right atrial samples were taken before cardiopulmonary bypass and fixed in 10% neutral formalin. Immunoperoxidase staining and TUNEL method were performed to detect apoptotic cells. The immunostained active caspase-3 and proliferating cell nuclear antigen (PCNA) cells were counted using a light microscope. Results: The mean apoptotic index was significantly lower in endocardial (p=0.04) and epicardial layers (p=0.01) of group 1 patients compared to those of group 2. Myocardial layer values were similar between the groups (p=0.35). The mean PCNA index in any layers was not significantly different between groups. Conclusion: Statin pretreatment before CABG seems to diminish cardiac myocyte loss, providing an explanation for their beneficial effects seen after open heart surgery.

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