Aprotinin reduces the IL-8 after coronary artery bypass grafting

The effect of aprotinin, a protease inhibitor, on myocardial interleukin-8 (IL-8) production after ischemia-reperfusion injury was investigated. Twent y patients who had elective coronary artery bypass grafting were included i n this study, Patients were randomly divided into two groups (n = 10 in eac h). Group A patients received high dose aprotinin (20,000 IU/kg as pretreat ment followed by 7500 IU/kg for 6 h) and Group B patients received normal s aline as a control. Serum IL-8 levels after the termination of cardiopulmon ary bypass (CPB) showed a significant improvement in aprotinin treated grou p compared to control group (70+/-42.6 vs 360.71+/-87.9 ng/ml) (P<0.005). L evels were also significantly higher at post-operative 24th hour in patient s who did not received aprotinin (340.16+/-92.10 vs 96.13+/-34.33 ng/ml). H owever at post-operative 48th hour levels were again higher in control (unt reated) group, but the difference was not statistically significant (78.8+/ -34.4 vs 42.8+/-9.29 ng/ml), Aprotinin prevented the IL-8 release from myocytes in ischemia-reperfusion injury. The mechanism is highly dependent on anti-protease activity of apro tinin. (C) 2001 The International Society for Cardiovascular Surgery. Publi shed by Elsevier Science Ltd. All rights reserved.