BACKGROUND: Myocardial ischemic damage is reduced by volatile anaesthetics in 
patients undergoing low-risk coronary artery bypass graft surgery; few and 
discordant results exist in other settings. We therefore performed a randomised 
controlled trial (sevoflurane vs. propofol) to compare cardiac troponin release 
in patients with coronary disease undergoing mitral surgery.
METHODS: Patients with coronary artery disease undergoing mitral surgery were 
randomly allocated to receive either sevoflurane (50 patients) or propofol (50 
patients) as main hypnotic. The primary endpoint of the study was peak 
post-operative cardiac troponin release defined as the maximum value among the 
post-operative values measured at intensive care unit arrival, 4 h later, on the 
first and second post-operative day.
RESULTS: There was no significant difference in post-operative peak troponin 
release, the median (25th-75th percentiles) values being 14.9 (10.1-22.1) ng/ml 
and 14.5 (8.8-17.6) ng/ml in the sevoflurane and propofol groups, respectively 
(P = 0.4). Fentanyl administration was different between the two groups: 1347 ± 
447 μg in patients receiving sevoflurane and 1670 ± 469 μg in those receiving 
propofol, P = 0.002. The 1-year follow-up identified two patients who died in 
the propofol group (one myocardial infarction and one low cardiac output 
syndrome) and one in the sevoflurane group (myocardial infarction).
CONCLUSION: In this study, patients with coronary artery disease undergoing 
mitral surgery did not benefit from the cardioprotective properties of 
halogenated anaesthetics. Sevoflurane anaesthesia was not associated to lower 
cardiac troponin release when compared with propofol anaesthesia.