The Effect of Zinc and Selenium Supplements on the Prevalence of Atrial Fibrillation after Coronary Artery Bypass Surgery: A Randomized Clinical Trial Study

Document Type : Original Article(s)

Authors

1 Associate Professor, Department of Anesthesiology, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 MSc of Perfusion, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: This study was conducted to determine the effect of zinc and selenium supplements on the incidence of atrial fibrillation after coronary artery bypass surgery.
Methods: In this clinical trial, 54 patients were randomly divided into two groups of 27. The intervention group received a daily capsule containing 200 micrograms of zinc and 15 mg of selenium a week before the operation, and the control group received a placebo. 24 hours before the operation, the zinc and selenium levels were checked. All patients after surgery were examined and compared in terms of clinical parameters including atrial fibrillation, cardiac ejection fraction, bleeding, and length of hospitalization in the intensive care unit and hospital.
Findings: The mean difference of cardiac ejection fraction in the intervention group was -2.41 ± 0.77% (increased) and in the control group was 2.78 ± 0.86% (decreased), and the difference between the two groups was significant (P < 0.001). During the study, 4 (14.8%) of the control group had ventricular fibrillation, and there was no case of AF in the intervention group, and the difference between the two groups was significant
(P = 0.015). The mean volume of bleeding (P = 0.011) and the mean length of hospital stay were significantly different between the two groups.
Conclusion: Prescribing zinc and selenium supplements before coronary artery bypass surgery can lead to a more favorable prognosis and reduce the incidence of ventricular fibrillation, reduce the length of hospital stay, and reduce the amount of bleeding after surgery.

Highlights

Mehran Shahzamani: Google Scholar, PubMed

Alireza Hoseini: Google Scholar, PubMed

Keywords

Main Subjects

References

  1. Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights. Circ Res 2020; 127(1): 4-20.
  2. Boriani G, Vitolo M, Diemberger I, Proietti M, Valenti AC, Malavasi VL, et al. Optimizing indices of atrial fibrillation susceptibility and burden to evaluate atrial fibrillation severity, risk and Cardiovasc Res 2021; 117(7): 1-21.
  3. Hou HT, Xue LG, Zhou JY, Wang SF, Yang Q, He GW. Alteration of plasma trace elements magnesium, copper, zinc, iron and calcium during and after coronary artery bypass grafting surgery. J Trace Elem Med Biol 2020; 62: 126612.
  4. Thorén E, Wernroth ML, Christersson C, Grinnemo KH, Jidéus L, Ståhle E. Compared with matched controls, patients with postoperative atrial fibrillation (POAF) have increased long-term AF after CABG, and POAF is further associated with increased ischemic stroke, heart failure and mortality even after adjustment for AF. Clin Res Cardiol 2020; 109(10): 1232-42.
  5. Eikelboom R, Sanjanwala R, Le ML, Yamashita MH, Arora RC. Postoperative atrial fibrillation after cardiac surgery: a systematic review and meta-analysis. Ann Thorac Surg 2021; 111(2): 544-54.
  6. Kyaruzi M, Iyigün T, Diker VO, Kurt BO, Kahraman Z, Onan B. Trace element status and postoperative morbidity after on-pump coronary artery bypass surgery. Biol Trace Elem Res 2023; 201(6): 2711-20.
  7. Huang J. Circulating concentrations of nutrition-related factors are not causally associated with atrial fibrillation: A Mendelian randomization study. J Cardiovasc Pharmacol 2022; 80(2): 210-5.
  8. Choi S, Liu X, Pan Z. Zinc deficiency and cellular oxidative stress: prognostic implications in cardiovascular diseases. Acta Pharmacol Sin 2018; 39(7): 1120-32. 
  9. El-Mahdy RI, Mostafa MM, El-Deen HS. Serum zinc measurement, total antioxidant capacity, and lipid peroxide among acute coronary syndrome patients with and without ST elevation. Appl Biochem Biotechnol 2019; 188(1): 208-24.
  10. Mattern L, Chen C, McClure LA, Brockman J, Cushman M, Judd S, et al. Serum zinc levels and incidence of ischemic stroke: the reasons for geographic and racial differences in stroke study. Stroke 2021; 52(12): 3953-60.
  11. Alehagen U, Aaseth J, Lindahl TL, Larsson A, Alexander J. Dietary supplementation with selenium and coenzyme Q10 prevents increase in plasma d-dimer while lowering cardiovascular mortality in an elderly Swedish population. Nutrients 2021; 13(4): 1344.
  12. Taghavi S, Qoreishi SAH, Nadri N, Amin A, Futuhi F, Kordrostami S, et al. Importance of serum selenium levels in acute heart failure. Iranian Heart J 2020; 21(3): 109-18.
  13. Kamali A, Amirani E, Asemi Z. Effects of selenium supplementation on metabolic status in patients undergoing for coronary artery bypass grafting (CABG) surgery: a randomized, double-blind, placebo-controlled trial. Biol Trace Elem Res 2019; 191(2): 331-7.
  14. Ardahanli I, Ozkan HI. Comparison of serum selenium levels between patients with newly diagnosed atrial fibrillation and normal Biol Trace Elem Res 2022; 200(9): 3925-31.
  15. Zakeri N, Rezaei Kelishadi M, Asbaghi O, Naeini F, Afsharfar M, Mirzadeh E, et al. Selenium supplementation and oxidative stress: A review. PharmaNutrition 2021; 17: 100263.
  16. Oster O, Dahm M, Oeler H. Element concentrations (selenium, copper, zinc, iron, magnesium, potassium, phosphorous) in heart tissue of patients with coronary heart disease correlated with physiological parameters of the heart. Eur Heart J 1993; 14(6): 770-4.
  17. de Lorgeril M, Salen P, Accominotti M, Cadau M, Steghens JP, Boucher F, et al. Dietary and blood antioxidants in patients with chronic heart failure. Insights into the potential importance of selenium in heart failure. Eur J Heart Fail 2001; 3(6): 661-9.
  18. Al-Mubarak A, Grote Beverborg N, Zwartkruis V, van Deutekom C, Gansevoort R, Bakker S, et al. Selenium deficiency is associated with new-onset atrial fibrillation in PREVEND: a prospective general population cohort. Eur J Prev Cardiol 2022; 29(Suppl 1): zwac056. 01.
  19. Miles LF, Kunz SA, Na L, Braat S, Burbury K, Story DA. Postoperative outcomes following cardiac surgery in non-anaemic iron-replete and iron-deficient patients-an exploratory study. Anaesthesia 2018; 73(4): 450-8.
  20. Zhang Z, Chang C, Zhang Y, Chai Z, Li J, Qiu C. The association between serum selenium concentration and prognosis in patients with heart failure in a Chinese population. Sci Rep 2021; 11(1): 1-9.
  21. Yoshihisa A, Abe S, Kiko T, Kimishima Y, Sato Y, Watanabe S, et al. Association of serum zinc level with prognosis in patients with heart failure. J Card Fail 2018; 24(6): 375-83
Journal of Isfahan Medical School
Volume 42, Issue 754
2nd Week, April
March and April 2024
Pages 35-42

Files

History

  • Receive Date: 14 September 2023
  • Accept Date: 18 February 2024

Share

How to cite

Statistics