Journal of Isfahan Medical School

Journal of Isfahan Medical School

A Comparative Study of the Effect of Melatonin and Coenzyme Q10 on Clinical Outcomes Following Coronary Artery Bypass Grafting Surgery

Document Type : Original Article(s)

Authors
Mojtaba Mansouri 1
Gholamreza Masoiumi 1
Mohsen Mirmohammadsadeghi 2
Amir Mir Mohammad Sadeghi 2
Amirreza Hemasian 3
1 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Resident of Cardiac Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jims.v43.i840.1543
Abstract
Background: The present study was conducted with the aim of comparing the effect of melatonin and coenzyme Q10 on the clinical outcomes following coronary artery bypass graft surgery.
Methods: In this clinical trial study, 90 patients who were candidates for coronary bypass grafting were divided into three groups of 30. The first group received 20 mg of melatonin and a placebo orally the night before and two hours before surgery. The second group received 150 mg of coenzyme Q10 and a placebo at the same time points. The third group received an oral placebo both the night before and two hours before surgery. Hemodynamic parameters, inotrope use, hemoglobin levels, serum urea and creatinine levels, and inflammatory factors were evaluated and compared among the three groups.
Findings: The frequency of inotrope consumption was 13(43.3%) in the melatonin group, 18(60%) in the Q10 group, and 23(82.1%) in the control group, and the difference between the three groups was significant (P=0.01). The mean level of CPK-MB in the melatonin group was 279.25±64.76, in the Q10 group 193.37±40.1, and in the control group was 453.21±61.46, and the difference between the three groups was significant(P=0.004).

Conclusion: Administration of melatonin and Q10 before coronary artery bypass graft surgery reduces the level of postoperative inflammatory factors. Furthermore, melatonin administration may be preferable to coenzyme Q10 due to its sedative effects and its role in maintaining greater blood pressure stability in patients

Highlights

Mojtaba Mansouri: Google Scholar, PubMed

Gholamreza Masoumi: Google Scholar, PubMed

Mohsen Mirmohamadsadeghi: PubMed

Amir Mirmohamad Sadeghi: PubMed

Amirreza Hemasian: PubMed

 

Keywords
Coronary artery bypass
Melatonin
Coenzyme Q10

Subjects

1.     Chatterjee S, Chaudhuri D, Vedanthan R, Fuster V, Ibanez B, Bangalore S, et al. Early intravenous beta-blockers in patients with acute coronary syndrome—a meta-analysis of randomized trials. Int J Cardiol 2013; 168(2): 915-21.
2.     Claustrat B, Leston J. Melatonin: Physiological effects in humans. Neurochirurgie 2015; 61(2-3): 77-84.
3.     Souissi A, Souissi N, Dabboubi R, Souissi N. Effect of melatonin on inflammatory response to prolonged exercise. Biological Rhythm Research. 2020; 51(4): 650-65.
4.     Yuge K, Nagamitsu S, Ishikawa Y, Hamada I, Takahashi H, Sugioka H, et al. Long-term melatonin treatment for the sleep problems and aberrant behaviors of children with neurodevelopmental disorders. BMC Psychiatry 2020; 20(1): 445.
5.     Simko F, Baka T, Paulis L, Reiter RJ. Elevated heart rate and nondipping heart rate as potential targets for melatonin: a review. J Pineal Res 2016; 61(2): 127-37.
6.     Sifuentes-Franco S, Sánchez-Macías DC, Carrillo-Ibarra S, Rivera-Valdés JJ, Zuñiga LY, Sánchez-López VA. Antioxidant and anti-inflammatory effects of coenzyme Q10 supplementation on infectious diseases. H Healthcare (Basel) 2022; 10(3): 487.
7.     Fotino AD, Thompson-Paul AM, Bazzano LA. Effect of coenzyme Q10 supplementation on heart failure: a meta-analysis. Am J Clin Nutr 2013; 97(2): 268-75.
8.     Moludi J, Keshavarz S, Tabaee AS, Safiri S, Pakzad R. Q10 supplementation effects on cardiac enzyme CK-MB and troponin in patients undergoing coronary artery bypass graft: a randomized, double-blinded, placebo-controlled clinical trial. J Cardiovasc Thorac Res 2016; 8(1): 1-7.
9.     Xie X, Shen T-t, Bi H-l, Su Z-l, Liao Z-q, Zhang Y, et al. Melatonin inhibits angiotensin II–induced atrial fibrillation through preventing degradation of Ang II Type I Receptor–Associated Protein (ATRAP). Biochem Pharmacol 2022; 202: 115146.
10.  Barati S, Jahangirifard A, Ahmadi ZH, Tavakoli-Ardakani M, Dastan F. The effects of melatonin on the oxidative stress and duration of atrial fibrillation after coronary artery bypass graft surgery: a randomized controlled trial. Endocr Metab Immune Disord Drug Targets 2021; 21(6): 1142-9.
11.  Makhija N, Sendasgupta C, Kiran U, Lakshmy R, Hote MP, Choudhary SK, et al. The role of oral coenzyme Q10 in patients undergoing coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2008; 22(6): 832-9.
12.  de Frutos F, Gea A, Hernandez-Estefania R, Rabago G. Prophylactic treatment with coenzyme Q10 in patients undergoing cardiac surgery: could an antioxidant reduce complications? A systematic review and meta-analysis. Interact Cardiovasc Thorac Surg 2015; 20(2): 254-9.
13.  Zhao S, Wu W, Liao J, Zhang X, Shen M, Li X, et al.

Molecular mechanisms underlying the renal protective effects of coenzyme Q10 in acute kidney injury. Cell Mol Biol Lett 2022; 27(1): 57.
14.  Russcher M, Koch B, Nagtegaal E, van der Putten K, ter Wee P, Gaillard C. The role of melatonin treatment in chronic kidney disease. Front Biosci (Landmark Ed) 2012; 17(7): 2644-56.
15.  Nasseh N, Khezri MB, Farzam S, Shiravandi S, Shafikhani AA. The effect of melatonin on cardiac biomarkers after coronary artery bypass graft surgery: A double-blind, randomized pilot study. J Cardiothorac Vasc Anesth 2022; 36(10): 3800-5.
16.  Dwaich KH, Al-Amran FG, Al-Sheibani BI, Yousif NG, Hadi NR. The cardioprotective role of melatonin against myocardial injury in patients undergoing coronary artery bypass grafting surgery. Vascular Investigation and Therapy 2018; 1(2): 41-9.
17.  Farshidianfar M, Ardekani A, Tabrizi R, Lankarani KB, Taherifard E, Abdollahi A, et al. Effects of melatonin on cardiac injury and inflammatory biomarkers in patients undergoing coronary artery bypass graft surgery: a meta-analysis. Cardiol Ther 2023; 12(1): 11-20.
18.  Cho JH, Bhutani S, Kim CH, Irwin MR. Anti-inflammatory effects of melatonin: A systematic review and meta-analysis of clinical trials. Brain Behav Immun 2021; 93: 245-53.
19.  Dominguez‐Rodriguez A, Abreu‐Gonzalez P, Sanchez‐Sanchez JJ, Kaski JC, Reiter RJ. Melatonin and circadian biology in human cardiovascular disease. J Pineal Res 2010; 49(1): 14-22.
20.  Emamgholipour S, Hossein-Nezhad A, Ansari M. Can Melatonin Act as an Antioxidant in Hydrogen Peroxide‐Induced Oxidative Stress Model in Human Peripheral Blood Mononuclear Cells? Biochem Res Int 2016; 2016(1): 5857940.
21.  Shafiei E, Bahtoei M, Raj P, Ostovar A, Iranpour D, Akbarzadeh S, et al. Effects of N-acetyl cysteine and melatonin on early reperfusion injury in patients undergoing coronary artery bypass grafting: A randomized, open-labeled, placebo-controlled trial. Medicine (Baltimore) 2018; 97(30): e11383.
22.  Fu Z, Jiao Y, Wang J, Zhang Y, Shen M, Reiter RJ, et al. Cardioprotective role of melatonin in acute myocardial infarction. Front Physiol 2020; 11: 366.
23.  Hajhossein-Talasaz A, Dianatkhah M, Ghaeli P, Salehiomran A, Dianatkhah M. Possible effects of melatonin on reperfusion injury following coronary artery bypass graft surgery. ARYA atheroscler 2022; 18(2): 1-7.
24.  Javanmard SH, Heshmat-Ghahdarijani K, Mirmohammad-Sadeghi M, Sonbolestan SA, Ziayi A. The effect of melatonin on endothelial dysfunction in patient undergoing coronary artery bypass grafting surgery. Adv Biomed Res 2016; 5: 174.
Journal of Isfahan Medical School
Volume 43, Issue 840
4th Week , January
January and February 2026
Pages 1543-1552

  • Receive Date 01 June 2024
  • Revise Date 06 August 2024
  • Accept Date 14 September 2024