Anti-inflammatory effects of 17 beta-estradiol pretreatment in men after coronary artery surgery

Objective: To investigate the anti-inflammatory and hemodynamic effects of 17 beta -estradiol in men undergoing elective coronary artery bypass graft surgery (CABG). Design: Prospective, randomized, controlled. Setting: Operating room and intensive care unit in a university hospital. Participants: Twenty-one men undergoing primary, elective CABG surgery. Intervention: 17 beta -estradiol, 2mg, was given orally twice in 14 hours b efore the operation. Measurements and Main Result. Leukocyte counts, plasma myeloperoxidase, tum or necrosis factor-alpha, interleukin (IL)-6, IL-8, and IL-10 were measured perioperatively. Leukocyte counts were lower in the 17 beta -estradiol gro up than in controls at 6 hours (11.4 +/- 2.0 hours v 15.5 +/- 4.7 hours X 1 0(9)/L) and 20 hours (11.6 +/- 1.9 hours v 13.6 +/- 2.5 hours x 109/L) afte r reperfusion (p = 0.03). The release of myeloperoxidase was lower in the 1 7 beta -estradiol group than in controls (5 minutes; 634.4 +/- 213.1 mug/mL v 773.1 +/- 209.3 mug/mL; 4 hours, 305.0 +/- 108.0 mug/mL v 441.3 +/- 191. 6 mug/mL; p = 0.02). Systemic vascular resistance index was lower just afte r cardiopulmonary bypass, and cardiac index was higher postoperatively in t he 17 beta -estradiol group as compared with controls. Conclusion: Pretreatment with 17 beta -estradiol can limit leukocyte activa tion in men after CABG surgery. Copyright (C) 2001 by WB. Saunders Company.