Systematic Review of Cardioprotective Effect of Sevoflurane Preconditioning on Patients Undergoing Coronary Artery Bypass Grafting with Cardiopulmonary Bypass

Objective To systematically assess the cardioprotective effect of Sevoflurane preconditioning on patients undergoing coronary artery bypass grafting with cardiopulmonary bypass using meta-analysis. Methods Randomized controlled trials of Sevoflurane preconditioning on patients undergoing coronary artery bypass grafting were identified from PubMed, EMBASE, CBMdisc, and Cochrane Library from 1998 to 2011. Data were evaluated and extracted by two reviewers independently with inclusion criteria. Data from randomized controlled trials were entered and analysed with RevMan 4.2 software. Results Five studies that recruited 294 patients were included for meta-analysis. Meta-analysis showed that in Sevoflurane group, postoperative peak cardiac troponin T（cTnT） concentrations was lower than control group [the weighted mean differences （WMD） was -0.21, 95%confidence interval was （-0.33,-0.09）, P<0.05], among these studies there was a significant heterogeneity（P<0.01）. In Sevoflurane group, peak postoperative N-terminal pro-brain natriuretic peptide（NT-ProBNP） concentrations and creatine kinase-MB（CK-MB） activity were lower, cardiac index （CI） were higher, the rate of postoperative adverse cardiac events were lower compared with control group. Conclusions Sevoflurane preconditioning exerts cardioprotective effect on patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.