ISSN (print) 1726-9806     ISSN (online) 1818-474X
No. 3 (2020), FUNDAMENTAL ISSUES IN ANESTHESIA AND INTENSIVE CARE
No. 3 (2020)
FUNDAMENTAL ISSUES IN ANESTHESIA AND INTENSIVE CARE

Cardioprotection with the use of exogenous phosphocreatine in general surgery and critical conditions. Review

Published 02.09.2020
A.G. Yavorovskiy
I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
https://orcid.org/0000-0001-5103-0304
Alexander M. Popov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
https://orcid.org/0000-0002-6490-7184
P.V. Nogtev
I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
https://orcid.org/0000-0002-5553-0880
#2020-3
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Keywords

Cardioprotection
Phosphocreatine
Myocardium
Perioperative Period
Intensive Care Units

How to Cite

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Yavorovskiy A.G., Popov A.M., Nogtev P.V. Cardioprotection with the use of exogenous phosphocreatine in general surgery and critical conditions. Review. Annals of Critical Care. 2020;(3):56-65. doi:10.21320/1818-474X-2020-3-56-65
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Abstract

The number of surgeries performed for the elderly and senile persons with concomitant cardiovascular pathology is increasing every year. It is in this category of patients that the likelihood of developing perioperative cardiac complications is highest, which requires the use of cardioprotective measures to reduce the risk of their occurrence. One of the options for cardioprotection may be the use of drugs aimed at improving metabolism and maintaining adequate energy supply to the myocardium. Such metabolic agent is exogenous phosphocreatine.

This article provides an overview of studies on the use of exogenous phosphocreatine as a cardioprotector in patients undergoing noncardiac surgery. The publications were searched for in PubMed / Medline, Embase, e-library, China National Knowledge Infrastructure, WANGFANG DATA. It has been shown that the use of phosphocreatine (PhC) in abdominal surgery, oncosurgery, during operations in traumatology, thoracic surgery, transplantation, as well as in intensive care units for sepsis and septic shock is associated with a decrease in the risk of cardiac complications and a reduction in mortality. Considering the above data on the positive cardioprotective effect of exogenous phosphocreatine in various surgeries, this protective agent can be recommended for wider application in clinical practice, especially in patients with high cardiac risk.

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References

  1. Kristensen S.D., Knuuti J., Saraste A., et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur. Heart. J. 2014; 35(35): 2383–2431. DOI: 10.1093/eurheartj/ehu282
  2. Добрушина О.Р., Корниенко А.Н., Шкловский Б.Л., Царев М.И. Оценка риска кардиальных осложнений при обширных абдоминальных операциях у больных пожилого и старческого возраста. Российский медицинский журнал. 2012; 1: 14–18. [Dobrushina O.R., Kornienko A.N., Shklovsky B.L., Tsarev M.I. Ocenka riska kardial’nyh oslozhnenij pri obshirnyh abdominal’nyh operaciyah u bol’nyh pozhilogo i starcheskogo vozrasta. Rossijskij medicinskij zhurnal. 2012; 1: 14–18. (In Russ)]
  3. Lee T.H., Marcantonio E.R., Mangione C.M., et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation. 1999; 100(10): 1043–1049.
  4. Zerbib P., Kulick J.F., Lebuffe G., et al. Emergency major abdominal surgery in patients over 85 years of age. World J. Surg. 2005; 29: 820–825.
  5. Devereaux P.J., Goldman L., Cook D.J., et al. Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk. CMAJ. 2005; 173(6): 627–634.
  6. Devereaux P.J., Sessler D.I. Cardiac Complications and Major Noncardiac Surgery. N. Engl. J. Med. 2016; 374(14): 1394–1395. DOI: 10.1056/NEJMc1516761
  7. Devereaux P.J., Yang H., Yusuf S., et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISEtrial): a randomised controlled trial. Lancet. 2008; 371(9627): 1839–1847. DOI: 10.1016/S0140-6736(08)60601-7
  8. Козлов И.А. Профилактика периоперационных кардиальных осложнений с помощью адъювантных лекарственных средств у некардиохирургических больных. Вестник интенсивной терапии. 2015; 5: 14–22. [Kozlov I.A. Profilaktika perioperacionnyh kardial’nyh oslozhnenij s pomoshch’yu ad”yuvantnyh lekarstvennyh sredstv u nekardiohirurgicheskih bol’nyh. Vestnik intensivnoj terapii. 2015; 5: 14–22. (In Russ)]
  9. Козлов И.А. Профилактика осложнений, обусловленных ишемией-реперфузией миокарда, при экстракардиальных оперативных вмешательствах. Бюллетень сибирской медицины. 2016; 15(3): 102–117. [Kozlov I.A. Profilaktika oslozhnenij, obuslovlennyh ishemiej-reperfuziej miokarda, pri ekstrakardial’nyh operativnyh vmeshatel’stvah. Byulleten’ sibirskoj mediciny. 2016; 15(3): 102–117. (In Russ)]
  10. Devereaux P.J., Duceppe E., Guyatt G., et al. MANAGE Investigators. Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial. Lancet. 2018. 391 (10137): 2325–2334. DOI: 10.1016/S0140-6736(18)30832-8
  11. Alvarez Escudero J., Calvo Vecino J.M., Veiras S., et al. Working Group of the CPG. Clinical Practice Guideline (CPG). Recommention strategy for reducing risk of heart failure patientsrequiring noncardiac surgery: reducing risk of heartfailure patients in noncardiac surgery. Rev. Esp. Anestesiol. Reanim. 2015; 62(7): 359–419. DOI: 10.1016/j.redar.2015.05.002
  12. De Hert S., Staender S., Fritsch G., et al. Preоperative evaluation of adults undergoing elective noncardiac surgery: Updated guideline from the European Society of Anaesthesiology. Eur. J. Anaesthesiol. 2018; 35(6): 407–465. DOI: 10.1097/EJA.000000000000081
  13. Kertai M.D., Westerhout C.M., Varga K.S., et al. Dihydropiridine calcium channel blockers and peri-operative mortality in aortic aneurysm surgery. Br. J. Anaesth. 2008; 101(4): 458–465. DOI: 10.1093/bja/aen173
  14. Wetterslev J., Juul A.B. Benefits and harms of perioperative beta-blockade. Best Pract. Res. Clin. Anaesthesiol. 2006; 20(2): 285–302. DOI: 10.1016/j.bpa.2005.10.006. PMID: 16850778
  15. Лихванцев В.В., Гребенчиков О.А. Анестетическое прекондиционирование. В кн.: Козлов И.А., Яворовский А.Г. (ред.). Адъювантная кардиопротекция у кардиохирургических больных. М.: ФармЭтика, 2017: 38–69. ISBN 978-5-9905473-2-2 50 [Likhvantsev V.V., Grebenchikov O.A. Anesteticheskoe prekondicionirovanie. V kn.: Kozlov I.A., YAvorovskij A.G. (red.). Ad”yuvantnaya kardioprotekciya u kardiohirurgicheskih bol’nyh. M.: FarmEtika, 2017: 38–69. (In Russ)]
  16. Van Allen N.R., Krafft P.R., Leitzke A.S., et al. The role of volatile anesthetics in cardioprotection: a systematic review. Med. Gas. Res. 2012; 2(1): 22. DOI: 10.1186/20459912-2-22
  17. Walker J.B. Creatine: biosynthesis, regulation, and function. Adv. Enzymol Relat. Areas. Mol. Biol. 1979; 50: 117–242.
  18. Landoni G., Zangrillo A., Lomivorotov V.V., et al. Cardiac protection with phosphocreatine: a meta-analysis. Interact Cardiovasc Thorac Surg. 2016; 23(4): 637–646. DOI: 10.1093/icvts/ivw171
  19. Mingxing F., Landoni G., Zangrillo A., et al. Phosphocreatine in Cardiac Surgery Patients: A Meta-Analysis of Randomized Controlled Trials. J. Cardiothorac Vasc. Anesth. 2017; Jul 24; pii: S1053-0770(17)30671-7. DOI: 10.1053/j.jvca.2017.07.024
  20. Козлов И.А., Яворовский А.Г. Экзогенный фосфокреатин как кардиопротектор в хирургии и интенсивной кардиологии. Аналитический обзор. Медицинский алфавит. 2018; 1(9): 18–27. [Kozlov I.A., Yavorovsky A.G. Ekzogennyj fosfokreatin kak kardioprotektor v hirurgii i intensivnoj kardiologii. Analiticheskij obzor. Medicinskij alfavit. 2018; 1(9): 18–27. (In Russ)]
  21. Прогнозирование и профилактика кардиальных осложнений внесердечных хирургических вмешательств. Национальные рекомендации, Всероссийское научное общество кардиологов, М., 2011. Режим доступа: http://www.scardio.ru/content/images/recommendation/rekomendacii_prognozirovanie_i_profilaktika_hirurgicheskih_oslozhne.pdf [Prognozirovanie i profilaktika kardial’nyh oslozhnenij vneserdechnyh hirurgicheskih vmeshatel’stv. Nacional’nye rekomendacii, Vserossijskoe nauchnoe obshchestvo kardiologov, M., 2011. Available from: http: //www.scardio.ru/content/images/recommendation/rekomendacii_prognozirovanie_i_profilaktika_hirurgicheskih_oslozhne.pdf (In Russ)]
  22. Bessman S.P., Geiger P.J. Transport of energy in muscle: the phos-phorylcreatine shuttle. Science. 1981; 211: 448–452.
  23. Bessman S.P., Mohan С. Phosphocreatine, exercise, protein synthesis, and insulin. In: PP De Deyn, B, Marescau, V. Stalon an IA Qureshi, eds. Guanidino Compounds in Biology and Medicine. London: John Libbey and Company, 1992: 181–186.
  24. Down W.H., Chasseaud L.F., Ballard S.A. The effect of intravenously administered phosphocreatine on ATP and phosphocreatine concentrations in the cardiac muscle of the rat. Arzneimittelforschung. 1983; 33: 552–554.
  25. Breccia A., Fini A., Girotti S., Gattavecchia E. Intracellular distribution of double-labelled creatine phosphate in the rabbit myocardium. Curr. Ther. Res. 1985; 37: 1205–1215.
  26. Preobrazhensky A.N., Javadov S.A., Saks V.A. Study of the hypothetical mechanism of protective effect of phosphocreatine on ischemic myocardium. Biochimia. 1986; 51: 675–683.
  27. Saks V.A., Strumia E. Phosphocreatine: Molecular and cellular aspects of the mechanism of cardioprotective action. Curr. Ther. Res. 1993; 53: 565–598.
  28. Сакс В.А. Фосфокреатиновый путь внутриклеточного транспорта энергии: современное состояние исследований. В кн.: Фосфокреатин: биохимическое и фармакологическое действие и клиническое применение / Под ред. В.А. Сакса, Ю.Г. Бобковой, Е. Струмпа. М.: Наука, 2014: 9–16 [Saks V.A. Fosfokreatinovyj put’ vnutrikletochnogo transporta energii: sovremennoe sostoyanie issledovanij. V kn.: Fosfokreatin: biohimicheskoe i farmakologicheskoe dejstvie i klinicheskoe primenenie / Pod red. V.A. Saksa, YU.G. Bobkovoj, E. Strumpa. M.: Nauka, 2014: 9–16. (In Russ)]
  29. Strumia E., Pelliccia F., D’Ambrosio G. Creatine phosphate: pharmacological and clinical perspectives. Adv. Ther. 2012; 29(2): 99–123. (In Russ)]
  30. Пиаценза Дж., Струмия Э., Лоренци Э., Боргоглио Р. Влияние фосфокреатина на эритроциты. В кн.: Фосфокреатин: биохимическое и фармакогическое действие и клиническое применение / Под ред. В.А. Сакса, Ю.Г. Бобковой, Е. Струмиа. М.: Наука, 2014: 316–324 [Piacenza J., Strumia E., Lorenzi E., Borgoglio R. Vliyanie fosfokreatina na eritrocity. V kn.: Fosfokreatin: biohimicheskoe i farmakogicheskoe dejstvie i klinicheskoe primenenie / Pod red. V.A. Saksa, YU.G. Bobkovoj, E. Strumia. M.: Nauka, 2014: 316–324. (In Russ)]
  31. Хмелевский Я.М., Дербугов В.Н., Худяков П.А., Полуэктова М.В. Применение фосфокреатина в качестве средства метаболической кардиотропной защиты в периоперационном периоде у больных старшей возрастной группы. Тезисы XIV съезда Федерации анестезиологов и реаниматологов. 2014: 333–334 [Khmelevsky Ya.M., Derbugov V.N., Khudyakov P.A., Poluektova M.V. Primenenie fosfokreatina v kachestve sredstva metabolicheskoj kardiotropnoj zashchity v perioperacionnom periode u bol’nyh starshej vozrastnoj gruppy. Tezisy XIV s”ezda Federacii anesteziologov i reanimatologov. 2014: 333–334. (In Russ)]
  32. Дербугов В.Н., Потапов А.Л., Потиевская В.И., Хмелевский Я.М. Применение экзогенного фосфокреатина у пациентов пожилого и старческого возраста, оперируемых по поводу колоректального рака. Общая реаниматология. 2017; 13(4): 38–45. DOI: 10.15360/1813-9779-2017-4-38-45. [Derbugov V.N., Potapov A.L., Potievskaya V.I., Khmelevsky Ya.M. Primenenie ekzogennogo fosfokreatina u pacientov pozhilogo i starcheskogo vozrasta, operiruemyh po povodu kolorektal’nogo raka. Obshchaya reanimatologiya. 2017; 13(4): 38–45. (In Russ)]
  33. Слепушкин В. Д., Мусабеков Р. Г., Доев Д. П. Адьювантная терапия фосфокреатином у пациентов с септическим шоком. Университетская клиника. 2018; 4(29): 22–28. ISSN 1819-0464. Режим доступа: http://journal.dnmu.ru/index.php/UC/article/view/147. Ссылка активна на 05.082019. DOI: https://doi.org/10.26435/uc.v0i4(29).147 [Slepushkin V. D., Musabekov R.G., Doev D.P. Ad’yuvantnaya terapiya fosfokreatinom u pacientov s septicheskim shokom. Universitetskaya klinika. 2018; 4(29): 22–28. Available at: http://journal.dnmu.ru/index.php/UC/article/view/147. Accessed: 05.082019. (In Russ)]
  34. Dai Jianqiang, Tu Weifeng Perioperative ventricular arrhythmia and related factors (J). J. Practical Medicine. 2004; 20(4): 461–3.
  35. Liu Tao, Chen Libing, Xu Meiying, et al. Effect of hyperglycemia on ischemia/reperfusion-induced ventricular arrythmia in isolated diabetic rat hearts (J). Chinese J. Anesthesiology. 2004: 24(9): 677–80.
  36. Wen-Long Z, Meng-Fei Y. The myocardial protective effect of sodium phosphocreatine on elderly patients with hip replacement operation. Chinese J. Gerontology. 2012; 32(2): 398–399.
  37. Xiao-Guang Y., Xia-Guang D., Yu-Ging K. China. The study of myocardial protective effect of creatine phosphate sodium in liver transplant patients. J. Modern Medicine. 2013: 19: 76–78
  38. Fleisher L.A., Fleischmann K.E., Auerbach A.D., et al. American College of Cardiology; American Heart Association. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: A report of the American college of cardiology. American heart association task force on practice guidelines. J. American College of Cardiology. 2014; 64(22): 77–137. Available at: https://doi.org/10.1016/j.jacc.2014.07.944
  39. Хороненко В.Э., Мандрыка Е.А., Баскаков Д.С., Суворин П.А. Адъювантная кардиопротекция в торакальной онкохирургии. Анестезиология и реаниматология. 2019; 1: 35–43 Режим доступа: https://doi.org/10.17116/anaesthesiology201901135 [Khoronenko V.E., Mandryka E.A., Baskakov D.S., Suvorin P.A. Ad”yuvantnaya kardioprotekciya v torakal’noj onkohirurgii. Anesteziologiya i reanimatologiya. 2019; 1: 35–43. Available at: https://doi.org/10.17116/anaesthesiology201901135 (In Russ)]
  40. Мясникова В.В., Карахалис Н.Б., Мусаева Т.С., Заболотских И.Б. Ведение пациентов с тахиаритмиями в периоперационном периоде при внесердечных хирургических вмешательствах. Вестник интенсивной терапии. 2017; 1: 37–55 [Myasnikova V.V., Karakhalis N.B., Musaeva T.S., Zabolotskikh I.B. Vedenie pacientov s tahiaritmiyami v perioperacionnom periode pri vneserdechnyh hirurgicheskih vmeshatel’stvah. Vestnik intensivnoj terapii. 2017; 1: 37–55. (In Russ)]
  41. De Decker K., Jorens P.G., Van Schil P. Cardiac complications after noncardiac thoracic surgery: an evidence-based current review. The Annals of Thoracic Surgery. 2003; 75(4): 1340–1348. DOI: 10.1016/s0003-4975(02)04824-5
  42. Хороненко В.Э., Шеметова М.М. Проблема периоперационного ведения пациентов с высоким риском развития аритмий сердца в онкохирургии. Анестезиология и реаниматология. 2012; 2: 78–81 [Khoronenko V.E., Shemetova M.M. Problema perioperacionnogo vedeniya pacientov s vysokim riskom razvitiya aritmij serdca v onkohirurgii. Anesteziologiya i reanimatologiya. 2012; 2: 78–81. (In Russ)]
  43. Herrington C.S., Shumway S.J. Myocardial ischemia and infarction postthoracotomy. Chest Surgery Clinics of North America. 1998; 8(3): 495–502.
  44. Horjus D.L., Oudman I., van Montfrans G.A., Brewster L.M. Creatine and creatine analogues in hypertension and cardiovascular disease. The Cochrane Database of Systematic Reviews. 2011; 11: CD005184. DOI: 10.1002/14651858.CD005184.pub2
  45. Hammill B.G., Curtis L.H., Bennett-Guerrero E., et al. Impact of heart failure on patients undergoing major noncardiac surgery. Anesthesiology. 2008(108): 559–567. DOI: 10.1097/ALN.0b013e31816725ef.
  46. Smilari L., La Mela C., Santagati A., et al. Study of left ventricular function in ischemic cardiomyopathies before and after phosphocreatine infusion. Echocardiographic study. Curr. Ther. Res. 1987; 41: 557–567.
  47. Ferraro S., Codella C., Palumbo F., et al. Hemodynamic effects of creatine phosphate in patients with congestive heart failure: a double-blind comparison trial versus placebo. Clin. Cardiol. 1996; 19: 699–703.
  48. Cafero M., Strumia E., Pirone S., et al. Effcacia della creatina fosfato nel trattamento dei pazienti con insuffcienza cardiaca, valutazione ecocardiografca dopo trattamento acuto e protratto. Clin. Ter. 1994; 144: 321–328 [Cafero M., Strumia E., Pirone S., et al. Efficacy of creatine phosphate in the treatment of patients with heart failure, echocardiographic evaluation after acute and protracted treatment. Clin. Ter. 1994; 144: 321–328. (In Ital)].
  49. Wang F.R., Zheng X. Effects of phosphocreatine on plasma brain natriuretic peptide level and left ventricular function in patients with heart failure. Liaoning: Affl iated Hospital, Chinese Medicine University. Published at PJCCPVD. August 2008; 16: 29–31.
  50. Галяутдинов Г.С., Коц Я.И., Вдовенко Л.Г. и др. Лечебное применение неотона при застойной сердечной недостаточности. В кн.: Неотон: современное состояние [Galyautdinov G.S., Kots Ya.I., Vdovenko L.G., et al. Lechebnoe primenenie neotona pri zastojnoj serdechnoj nedostatochnosti. V kn.: Neoton: sovremennoe sostoyanie. (In Russ)]
  51. Симаков А.А., Кулямина О.В., Галушков С.В. и др. Есть ли основания для назначения метаболической терапии больным с сердечной недостаточностью? Российские медицинские вести. 2011; 16(1): 80–85 [Simakov A.A., Kulyamina O.V., Galushkov S.V., et al. Est’ li osnovaniya dlya naznacheniya metabolicheskoj terapii bol’nym s serdechnoj nedostatochnost’yu? Rossijskie medicinskie vesti. 2011; 16(1): 80–85. (In Russ)]
  52. Wang W., Yu W.-Y., Lv J., Chen L.-H., Li Z. Effect of creatine phosphate sodium on bispectral index and recovery quality during the general anaesthesia emergence period in elderly patients: A randomized, double-blind, placebo-controlled trial. J. International Medical Research. 2018: 1063–1072. DOI:10.1177/0300060517744957
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