Role Of Cytokine Gene Polymorphisms On Ramipril-Altered Inflammatory Response And Myocardial Injury In Patients Undergoing Coronary Artery Bypass Surgery

Purpose: Ramipril is effective in treating inflammatory myocardial injury by reducing cytokines such as TNF-alpha, IL-6, and IL-8. In this study, we investigated the effect of cytokine gene polymorphisms on inflammatory response which might be reduced by ramipril.Material and Methods: Of 102 patients undergoing on-pump coronary artery bypass grafting surgery, 51 were the treatment group which received ramipril and the remaining 51 were the non-treated control group. TNF-a, IL-6, and IL-8 were measured with Enzyme-Linked Immuno Sorbent Assay (ELISA), before anesthesia induction (t1), at 20 min following cross clamping (t2), at the end of the operation (t3), and 24 hours after anesthesia (t4). Genotyping was performed with PCR method.Results: While TNF-alpha increase began with surgery, IL-6 and IL-8 increase began with cardiac arrest during cardiopulmonary bypass and continued until the end of the operation. In contrast, only IL-8 remained high in the control group during the postoperative period, while TNF-alpha, IL-6, and IL-8 began to decrease. The decreases in IL-6 at t3 and in TNF-alpha at t4 were significant.Conclusion: Ramipril might have a role in preventing inflammatory myocardial injury by reducing cytokine and TnT levels after cardiac arrest.