• Nahid Nasseh, Marzieh Beigom Khezri, Saeed Farzam, Saeedeh Shiravandi, and Ali Akbar Shafikhani.
• Department of Anesthesiology, Faculty of Medicine, Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Shahid Bahonar Ave., PO Box 3419759811, Qazvin, Iran.
• J. Cardiothorac. Vasc. Anesth. 2022 Oct 1; 36 (10): 3800-3805.

ObjectivesMelatonin has emerged as an anti-inflammatory agent, potent direct free-radical scavenger, and an indirect antioxidant in preventing ischemia-reperfusion injury. This study aimed to evaluate melatonin's effect on cardiac biomarkers after coronary artery bypass grafting (CABG).DesignA double-blind, randomized placebo-controlled pilot clinical study.SettingBooali Sina Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.ParticipantsOne hundred patients undergoing elective CABG. The patients were divided randomly into control (C) and melatonin (M) groups (50 patients per group).InterventionsThe M group received 3 mg of melatonin the night before surgery, 3 mg in the morning, and routine cardiac surgery medications. The C group received 1 placebo tablet rather than melatonin. After surgery, the patients in the M group received 3 mg of melatonin, and the C group received 1 placebo tablet at bedtime until the third day after CABG.Measurements And Main ResultsIn both groups, creatine kinase-MB (CPK-MB), cardiac troponin I, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were measured before surgery and on the first, second, and third postoperative days. Serum CPK-MB levels on the second and third day after CABG were significantly lower in the M group than in the C group (p < 0.05). Regarding cardiac troponin I, CRP, and ESR markers, there were no significant changes in serum concentration before surgery and on the first, second, and third days after surgery between the 2 groups (p > 0.05). The mean length of hospitalization in the ICU was lower in the M group (3.4 ± 1.05) compared with the C group (3.96 ± 1.06, p = 0.01).ConclusionMelatonin reduced the postoperative level of CPK-MB and the length of hospitalization in the ICU in patients who underwent cardiac surgery.Copyright © 2022. Published by Elsevier Inc.

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