The S-100B substudy of the GLUTAMICS trial: Glutamate infusion not associated with sustained elevation of plasma S-100B after coronary surgery
2010 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 29, no 3, 358-364 p.Article in journal (Refereed) Published
Background and aims: Concerns have been raised about potential neurological injury related to exogenous glutamate. In cardiac surgery glutamate has been administered as a putative cardioprotective agent by cardioplegia or intravenous infusion. In the GLUTAMICS trial, in addition to surveillance of clinical neurological injuries, a prespecified subgroup was analyzed with regard to postoperative S-100B levels to detect potential subclinical neurological injury related to glutamate infusion. Methods: Sixty-nine patients operated on for unstable coronary syndrome were randomized to intravenous infusion of glutamate (n = 35) or saline (n = 34) perioperatively. Plasma levels of S-100B were obtained on the third postoperative day. Results: S-100B in the glutamate group and the control group were 0.079 +/- 0.034 mu g/L and 0.090 +/- 0.042 mu g/L respectively (p = 0.245). There were no patients with stroke or mortality. Three patients in the control group and two in the glutamate group had postoperative confusion. These patients had significantly elevated S-100B compared with those without confusion (0.132 +/- 0.047 vs 0.081 +/- 0.036 mu g/L; p = 0.003). Overall, 21 patients had S-100B above reference level (greater than= 0.10 mu g/L) and these patients had significantly more calcifications in the ascending aorta on epiaortic scanning. Conclusions: Intravenous glutamate infusion during surgery for unstable coronary artery disease did not initiate a sustained elevation of plasma S-100B. Thus, no evidence for subclinical neurological injury related to glutamate infusion was found. In contrast, postoperative elevation of plasma S-100B was linked to calcification of the ascending aorta and postoperative confusion.
Place, publisher, year, edition, pages
Elsevier Science B.V., Amsterdam , 2010. Vol. 29, no 3, 358-364 p.
Glutamate; Neurological injury; Nutrition; Coronary artery bypass surgery; Myocardial protection; Stroke
Nutrition and Dietetics
IdentifiersURN: urn:nbn:se:liu:diva-58272DOI: 10.1016/j.clnu.2009.09.007ISI: 000279413100013PubMedID: 19853332OAI: oai:DiVA.org:liu-58272DiVA: diva2:337942