The effectivenes of the olmesartan medoximil in reducing the systemic inflammatory response in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass device

Systemic inflammatory response syndrome (SIRS) is common following coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB). It is known that olmesartan, an angiotensin II receptor blocker, reduces the inflammatory reactions. In this study, the effect of olmesartan therapy in patients undergoing CBP was evaluated on SIRS in patients undergoing CBP.The study included 50 patients (14 women, 36 men) aged between 30 and 80 years, those were randomly divided into two groups (Group K: control; Group O: olmesartan). Patients in the group K were not given any treatment. Patients in the group O were administered olmesartan 10 mg/day as daily single dose beginning preoperatively 5 days before the surgery and continuing until postoperative day 35; patients in this group were given 30 mg olmesartan on the day of surgery. Six blood specimens were collected from each patient in different times, prior to the induction of anesthesia (T1), 5 minutes after the insertion of cross clamp (T2), 5 minutes after the removal of cross clamp (T3), after protamine infusion (T4), on the postoperative day 3 (T5), and on the postoperative day 35 (T6). Serum levels of IL-6, IL-10 and IL-18 were analyzed in each specimen. The level of h-CRP was also determined in preoperative basal (T1) and postoperative day 35 (T2) serum specimens.It was found that h-CRP levels of the patients given olmesartan reduced significantly on the postoperative day 35 (p<0.05). In both groups, it was observed that in comparison with the period prior to the induction, IL-6 levels significantly increased in other periods (p<0.05). It was found that IL-10 level increased gradually and significantly during the surgery in all patients, in the postoperative period, although it reduced, it was still higher than basal level (p<0.05). It was observed that IL-18 level increased in both groups in comparison with basal levels (p<0.05) and this increase was more remarkable in olmesartan group (p<0.05).We concluded that the use of olmesartan in CABG operations did not reduce levels and effects of IL-6, IL-18, but increased levels of IL-10 and decreased possible complications especially with decreasing inflammatory responce (h-CRP) in postoperative period.Keywords: Systemic inflammatory response syndrome, h-CRP, Interleukin-6, Interleukin-10, Interleukin-18