Construction of preclinical evidence for propofol in the treatment of reperfusion injury after acute myocardial infarction: A systematic review and meta-analysis - 27/04/24
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Abstract |
Propofol, a commonly used intravenous anesthetic, has demonstrated potential in protecting against myocardial ischemia/reperfusion injury (MIRI) based on preclinical animal studies. However, the clinical benefits of propofol in this context are subject to debate. We conducted a systematic search across eight databases to identify all relevant animal studies investigating the preventive effects of propofol on MIRI until October 30, 2023. We assessed the methodological quality of the included studies using SYRCLE's bias risk tool. Statistical analysis was performed using STATA 15.1. The primary outcome measures analyzed in this study were myocardial infarct size (IS) and myocardial injury biomarkers. This study presents a comprehensive analysis of 48 relevant animal studies investigating propofol's preventive effects on MIRI. Propofol administration demonstrated a reduction in myocardial IS and decreased levels of myocardial injury biomarkers (CK-MB, LDH, cTnI). Moreover, propofol improved myocardial function parameters (+dp/dtmax, -dP/dtmax, LVEF, LVFS), exhibited favorable effects on inflammatory markers (IL-6, TNF-α) and oxidative stress markers (SOD, MDA), and reduced myocardial cell apoptotic index (AI). These findings suggest propofol exerts cardioprotective effects by reducing myocardial injury, decreasing infarct size, and improving heart function. However, the absence of animal models that accurately represent comorbidities such as aging and hypertension, as well as inconsistent administration methods that align with clinical practice, may hinder its clinical translation. Further robust investigations are required to validate these findings, elucidate the underlying mechanisms of propofol, and facilitate its potential translation into clinical practice.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Propofol attenuates infarct size and enhances myocardial function in healthy or diabetes animal with myocardial ischemia/reperfusion injury. |
• | Propofol demonstrates protective effects by the regulation of antioxidant, anti-apoptotic, pro-inflammatory, and pro-apoptotic factors. |
• | The therapeutic efficacy of propofol is influenced by the dosage and administration method of the drug. |
• | The clinical translation of propofol may be limited by the absence of comorbidities, as well as the use of administration methods. |
Chemical compounds studied in this article : Propofol (PubChem CID: 4943)
Abbreviations : AMI, AI, Bax, Bcl-2, CK, cTnI, DAMPs, IL-6, iNOS, IR, IS, LDH, MIRI, MDA, NLRP3, OS, PCI, PTCA, ROS, SOD, TNF-α, +dp/dtmax, -dP/dtmax, LVEF, LVFS
Keywords : Propofol, Myocardial ischemia/reperfusion injury, Mechanism of action, Preclinical study, Meta-analysis, Systematic review
Plan
Vol 174
Article 116629- mai 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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