Effects of spironolactone on hypoxia-inducible factor-1α in the patients receiving coronary artery bypass grafting.

Abstract

ABSTRACT\nWe explored the protective effect of spironolactone on cardiac function in the patients undergoing coronary artery bypass grafting (CABG) by determining serum hypoxia-inducible factor-1α (HIF-1α) before and after CABG. We used PSM (propensity score matching) method retrospectively to select 174 patients undergoing CABG in our hospital from March 2018 to December 2019. Of the 174 patients, 87 patients taking spironolactone for more than 3 months before CABG were used as a test group, and other 87 patients without taking spironolactone as a control group. In all patients, serum HIF-1α and troponin I levels were determined before as well as 24 hours and 7 days after CABG, serum NT-proBNP (N-terminal pro-brain natriuretic peptide) was determined before as well as 12 hours, 24 hours and 36 hours after CABG, electrocardiographic monitoring was carried out within 36 hours after CABG. Results indicated that there were no significant differences in the HIF-1α level between the test group and the control group before and 7 days after CABG, but the HIF-1α level was significantly lower in the test group than in the control group 24 hours after CABG (P <0.01). The two groups were not significantly different in the troponin I level at any time point. There was no significant difference in the serum NT-proBNP level between the test group and the control group before CABG, but NT-proBNP (BNP) levels were all significantly lower in the test group than in the control group at postoperative 12h, 24h and 36h time points, respectively (all P <0.05). The incidence of postoperative atrial fibrillation was also significantly lower in the test group than in the control group (P=0.035). Spironolactone protects cardiac function probably by improving myocardial hypoxia and inhibiting myocardial remodeling.