Efficacy of propofol-supplemented cardioplegia on biomarkers of organ injury in patients having cardiac surgery using cardiopulmonary bypass: A protocol for a randomised controlled study (ProMPT2)

Perfusion. 2024 May;39(4):722-732. doi: 10.1177/02676591231157269. Epub 2023 Feb 16.

Abstract

Introduction: Cardiac surgery with cardiopulmonary bypass and cardioplegic arrest is known to be responsible for ischaemia and reperfusion organ injury. In a previous study, ProMPT, in patients undergoing coronary artery bypass or aortic valve surgery we demonstrated improved cardiac protection when supplementing the cardioplegia solution with propofol (6 mcg/ml). The aim of the ProMPT2 study is to determine whether higher levels of propofol added to the cardioplegia could result in increased cardiac protection.

Methods and analysis: The ProMPT2 study is a multi-centre, parallel, three-group, randomised controlled trial in adults undergoing non-emergency isolated coronary artery bypass graft surgery with cardiopulmonary bypass. A total of 240 patients will be randomised in a 1:1:1 ratio to receive either cardioplegia supplementation with high dose of propofol (12 mcg/ml), low dose of propofol (6 mcg/ml) or placebo (saline). The primary outcome is myocardial injury, assessed by serial measurements of myocardial troponin T up to 48 hours after surgery. Secondary outcomes include biomarkers of renal function (creatinine) and metabolism (lactate).

Ethics and dissemination: The trial received research ethics approval from South Central - Berkshire B Research Ethics Committee and Medicines and Healthcare products Regulatory Agency in September 2018. Any findings will be shared though peer-reviewed publications and presented at international and national meetings. Participants will be informed of results through patient organisations and newsletters.

Trial registration: ISRCTN15255199. Registered in March 2019.

Keywords: cardiac surgery; cardioplegia; cardiopulmonary bypass; ischemia; propofol; randomised controlled trial; reperfusion.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study
  • Clinical Trial Protocol

MeSH terms

  • Adult
  • Biomarkers* / blood
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / methods
  • Cardiopulmonary Bypass* / adverse effects
  • Cardiopulmonary Bypass* / methods
  • Female
  • Heart Arrest, Induced* / methods
  • Humans
  • Male
  • Propofol* / pharmacology
  • Propofol* / therapeutic use

Substances

  • Propofol
  • Biomarkers