Effect of Multi-trace Elements Supplementation on Biochemical Markers and Postoperative Outcome in Patients Undergoing Elective Cardiac Surgery.

BACKGROUND

Coronary Artery Bypass Graft (CABG) surgery is employed to increase the lifespan of patients with Coronary Artery Disease (CAD). The low serum levels of essential elements have a negative effect on patients undergoing CABG.

OBJECTIVE

This clinical trial aimed to investigate the effect of trace elements supplements on postoperative outcomes after coronary artery bypass graft.

METHODS

Two hundred patients underwent on-pump CABG to randomly receive either Addamel©, which contains essential trace elements, or isotonic saline for 3 days. We measured postoperative plasma Zn, Se, Cu, Mn, Se, and Fe concentrations, and the levels of highly sensitive C-reactive Protein (hs-CRP) on days 0, 1, and 2. Duration of hospital and Intensive Care Unit (ICU) stay, 30-day mortality, and the incidence of Arterial Fibrillation (AF) have been evaluated as secondary outcomes.

RESULTS

In the supplemented group, the plasma levels of Cu and Mn increased by day 3, and plasma hs-CRP increased by day 1 in both groups, but it decreased in patients who received trace elements supplementation on day 2. The Addamel group had a lower mortality rate, though the difference did not reach a significant level. There was a significant negative correlation observed between plasma Zn level and 30-day mortality, along with another significant negative link between plasma CRP level before operation and Sepsis-related Organ Failure Assessment (SOFA) score. Other measured parameters were similar between the intervention and placebo groups.

CONCLUSION

The patients undergoing CABG appeared to benefit from trace element supplementation. A brief period of Addamel administration following CABG could prevent a decrease in the serum concentration of trace elements and reduce the circulating plasma CRP.