Relationship with previous studies
chronic heart failure, ischemic heart disease, ischemia, anoxia, inotropes/vasopressors
ANOXIA, CHRONIC HEART FAILURE, ISCHEMIC HEART DISEASE, ISCHEMIA
Endogenous PCr plays a pivotal role in normal myocardial metabolism. While experimental animals with completely undetectable levels of creatine and PCr demonstrated increased susceptibility to acute stress [Cardioprotective properties of PCr were first described in early seventies by Parratt J. and Marshall R., who showed that exogenous PCr supplementation protected isolated cardiac muscle from the consequences of anoxia [Numerous studies showed that exogenous PCr administration was able to decrease intraoperative inotrope use [In a meta-analysis of 41 randomized controlled and case-matched studies, Landoni et al. evaluated the influence of PCr supplementation in patients with ischemic heart disease or chronic heart failure or those undergoing cardiac surgery on all-cause mortality [A recent meta-analysis of randomized studies evaluated whether PCr can protect the heart from ischemia and decrease the need for inotropes/vasopressors after cardiac surgery [Thus, beneficial effects of exogenous PCr were observed in studies with high risk of bias. Our study was a first randomized, double-blind, placebo-controlled high-quality trial and this can explain the difference in the findings.While in the majority of previously published studies St. Thomas’ Hospital solution was used for myocardial protection, we utilized Custodiol cardioplegia which is a better method of myocardial protection in patients undergoing valvular procedures [