Combined effects of the implementation of magnesium and ascorbic acid on myocardial ischemia-reperfusion in open heart surgery

Abstract

Aim: This study aimed to investigate the combined effects of magnesium (Mg) and high dose ascorbic acid on cardiac ischemia-reperfusion (IR) injury. Material and Method: This study was performed on 45 patients that were scheduled for coronary artery bypass graft (CABG) operations. The patients were divided into three equal groups. Group C received 50 mg/kg ascorbic acid; Group CM received the same dose of ascorbic acid plus 30 mg/kg Mg; Group K received neither ascorbic acid nor Mg. At various times during the operation, the blood levels of malondialdehyde (MDA), serum creatine kinase MB (CK-MB), and lactate dehydrogenase (LDH) levels were analyzed. Results: There were statistically significant decreases in arrhythmia requiring intervention in Group CM compared to Group K (P=0.026). MDA levels increased in all groups but MDA 2 and MDA 3 levels were found to be statistically significantly lower in Group C and Group CM than in Group K (P=0.009, P=0.012, P=0.009 and P=0.006 respectively). However, inhibition of lipid peroxidation in both Group C and Group CM was not parallel to cardiac enzymes and hemodynamic measurements. There was no significant statistical difference in the cardiac enzyme levels between Group K, Group C, and Group CM (p>0.05). Conclusion: To reduce the IR, Mg with a high dose of ascorbic acid may be efficacious in patients undergoing cardiac surgery. A larger population group is needed to prove the results of this study.

Keywords

• Open heart surgery
• ascorbic acid
• magnesium
• ischemia-reperfusion.

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