Effects of single antegrade hot shot in comparison with no hot shot administration during coronary artery bypass grafting

Background: superior results will be achieved from cardiac surgery by minimizing the effectof ischemia/reperfusion injury during cross-clamping of the aorta. different cardioplegiasolutions have been introduced, but the optimum one is still ambiguous. the aim of this study isto determine the effect of single antegrade hot shot terminal warm blood cardioplegia (twbc)on patients who had undergone coronary artery bypass grafting (cabg).methods: in total, 2488 patients who had cabg surgery in sina hospital, isfahan, iran, from2003 to 2011 were enrolled in this case-control study. they were divided into two groups, thosewho received cold cardioplegia only and those who received a hot shot following coldcardioplegia. demographics, and clinical data, such as; premature atrial contraction (pac)arrhythmia, diabetes treatment, and left ventricular ejection fraction (ef), were collected andlogistic regression analysis was used to analyze the data.results: there were significant differences found between subjects receiving antegrade hotshot based on direct current (dc) shocks, with regard to; female, ef levels, diabetes treatment(p < 0.050). those who did not receive the hot shot and were not diabetic received more dcshock (p = 0.019). the prevalence of subjects who did no need dc shock was significantly higheramong male subjects who had good ef and acceptable diabetic treatment. multiple logisticregression showed that pac arrhythmia did not have a significant effect on receiving dc shockduring cagb [0.84 (0.25, 2.85), (p = 0.780)]. having poor ef increased the risk of receiving dcshock among subjects by 2.81 [(1.69, 4.69), (p ? 0.001)] (p < 0.001). among the diabeticsubjects, receiving insulin decreased the risk of receiving dc shock by 0.54 (0.29, 0.98)(p = 0.042).conclusion: it was concluded that single antegrade hot shot following cold cardioplegia wasnot particularly effective in the cabg group. twbc will decrease the need for dc shock.