Effects of silymarin on coronary artery bypass grafting

Abstract

Background: Coronary artery bypass grafting (CABG) is associated with a systemic inflammatory response. Systemic inflammatory response with secretion of cytokines & activation of leukocytes & endothelial cells is induced by CABG surgery; proinflammatory cytokines such as TNF_α, IL_1β are released in to the circulation in response to CABG surgery & have been suggested to play an important role in the pathogenesis of myocardial dysfunction in ischaemia reperfusion injury. Silymarin is a polyphenolic flavonoid derived from milk thistle (Silybum marianum) that has antioxidant, anti-inflammatory, cytoprotective effects, silymarin inhibit TNF_α & IL_1β.This study was designed to elucidate the anti-inflammatory effect of silymarin in CABG patients.Patients & methods: Thirty patients scheduled for CABG surgery in a prospective, randomized study. Twenty patients received silymarin 140 mg cap. Three times daily, given 3 days before surgery, then compared to the control group. Blood sample was drawn before & after surgery for full investigation; WBCs, differential counts; Neutrophils, Monocytes, Lymphocytes, Hb, PCV, ESR, total cholesterol, LDL, HDL, Triglycerides, SGOT, SGPT. B.urea, S.creatinin.Results: There was a decrease in post operative values of WBCs, Neutrophil, monocyte, lymphocyte, ESR, total cholesterol, SGOT, SGPT, B.urea, S.creatinine in patients treated with silymarin, compared to control. There was an increase in postoperative values of HDL in treated patients compared to control.Conclusion: Silymarin treatment is associated with an effect on the measured parameters. The data suggest that this drug may have a direct anti-inflammatory effect which explains its clinical benefit.

Keywords

Silymarin, CABG.