Evidence map›Paper›PMID 30045259›Full record

Trial reportMedicine2018

Effects of N-acetyl cysteine and melatonin on early reperfusion injury in patients undergoing coronary artery bypass grafting: A randomized, open-labeled, placebo-controlled trial.

Ebrahim Shafiei, Mehrzad Bahtoei, Pema Raj, Afshin Ostovar, Daryoush Iranpour, Samad Akbarzadeh, Hooshang Shahryari, Abdorasoul Anvaripour, Rahim Tahmasebi, Thomas Netticadan and 1 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 4 pooled it
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.

  1. Pooled it
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  13. Immunometabolism in the Aging Heart.Journal of the American Heart Association · 2025
    Review
  14. Melatonin, an Antitumor Necrosis Factor Therapy.Journal of pineal research · 2025
    Review
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  16. Review
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  18. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 2 countries.

Ebrahim ShafieiDepartment of Cardiology Department of Internal Medicine, Faculty of Medicine Biochemistry Group, the Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran Physiology and Pathophysiology, University of Manitoba Canadian Center for Agri-food Research in Health and Medicine, Winnipeg, Manitoba, Canada.
Mehrzad Bahtoei
Pema Raj
Afshin Ostovar
Daryoush Iranpour
Samad Akbarzadeh
Hooshang Shahryari
Abdorasoul Anvaripour
Rahim Tahmasebi
Thomas Netticadan
Ali Movahed
Bushehr University of Medical Sciences · IRUniversity of Manitoba · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study assessed the efficacy of oral consumption of N-acetyl cysteine (NAC) and melatonin (ML) in reducing early reperfusion injury and acute oxidative stress in patients undergoing coronary artery bypass grafting (CABG) with respect to the measurements of cardiac troponin I, lactate, malondealdehyde (MDA), and tumor necrosis factor-α (TNF-α) levels in the blood.

methodsThis study was a randomized, open-label, placebo-controlled trial. Eighty eight patients, aged between 39 to 76 years and eligible for CABG, were recruited and randomly assigned into 3 intervention groups through a simple randomization method and underwent CABG surgery. Blood samples were withdrawn from arterial line, before the induction of anesthesia (before the start of surgery), after incision (before aortic cross-clamping), during global ischemia (during aortic cross-clamping), after aortic cross-clamping (on set of reperfusion), 15 minutes after reperfusion, and after recovery at the intense care unit. The blood samples were analyzed for troponin I, lactate, MDA and TNF-α levels.

resultsThere was no significant difference in influencing variables among the groups at the baseline. Overall mean troponin I, lactate, and TNF- α levels were significantly different between the intervention groups (all P < .001) at the recovery phase. Post-hoc pairwise comparisons showed that the differences of mean serum levels between ML and control groups were statistically significant for MDA, TNF- α, lactate, and troponin I (P < .001, P = .001, and P = .001, respectively). The differences between NAC and control groups and between ML and NAC groups were only significant for mean lactate level (P < .001).

conclusionThe current study revealed that ML and NAC are potent antioxidants with similar efficacy in terms of reducing CABG related cardiac injury and oxidative stress with the dosage employed for the intervention.

Indexed as

Coronary DiseaseMyocardial Reperfusion InjuryAcetylcysteineAdultAgedAntioxidantsCardiotonic AgentsCoronary Artery BypassDrug MonitoringFemaleHumansMaleMelatoninMiddle AgedOxidative StressTreatment OutcomeAcetylcysteineAntioxidantsCardiotonic AgentsMelatonin

Identifiers

PMID30045259
PMCPMC6078764
OpenAlexW2882974690

What OpenQuestion holds

Textmetadata
LicenceCC BY-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.