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This was a prospective; randomized; single-blinded placebo-controlled study conducted at cardio-thoracic surgery department of the Academy of the Cardiovascular and Thoracic Surgery, Ain Shams University. Eligible patients were randomly allocated to; melatonin-treated group (MTG) or placebo-treated group (PTG). The MTG (<jats:italic>n<\/jats:italic>\u2009=\u200917) received 60\u00a0mg\/day melatonin capsules daily starting 5 days before surgery in addition to the standard of care. PTG (<jats:italic>n<\/jats:italic>\u2009=\u200917) received placebo also 5 days before surgery plus standard of care. The levels of nuclear factor kappa beta (NF-\u03bab) (primary outcome), tumor necrosis factor (TNF-\u03b1), cardiac troponins I, and IL-6 levels were all assessed for both groups at five time points: baseline before melatonin or placebo administration (T0), before cross-clamp application(T1), 5\u00a0min after cross-clamp removal(T2), 6\u00a0h after cross-clamp removal(T3) and 24\u00a0h after cross-clamp removal(T4). Blood pressure was assessed at baseline, pre-operative and 24-hours post-operative. The Quality of recovery-40 score (QOR-40) was assessed for both groups on day 4 after surgery. TNF-\u03b1 levels decreased in the MTG at T1(<jats:italic>p<\/jats:italic>\u2009=\u20090.034) versus PTG. At T2(<jats:italic>p<\/jats:italic>\u2009=\u20090.005), and T3(<jats:italic>p<\/jats:italic>\u2009=\u20090.04), TNF-\u03b1 significantly increased in PTG versus MTG. Troponins significantly increased in PTG at T3 (<jats:italic>p<\/jats:italic>\u2009=\u20090.04) versus MTG. NF-\u03baB levels declined at T1 (<jats:italic>p<\/jats:italic>\u2009=\u20090.013) and T2 (<jats:italic>p<\/jats:italic>\u2009=\u20090.0001) in MTG compared to PTG. IL-6 significantly increased in PTG versus MTG at T3 (<jats:italic>p<\/jats:italic>\u2009=\u20090.04). The QOR-40 score significantly decreased in MTG versus PTG. MTG had statistically significant decrease in DBP compared to the placebo group (<jats:italic>p<\/jats:italic>\u2009=\u20090.024). MTG had a statistically significant shorter intubation time than did the placebo group (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). Melatonin 60\u00a0mg was well-tolerated without any reported side effects. Our findings suggested that melatonin could ameliorate myocardial I\/R injury after on-pump CABG and that this outcome was essentially correlated to its antiapoptotic and anti-inflammatory effects. Trial registration: ClinicalTrials.gov registration number NCT05552586, 9\/2022.<\/jats:p>","DOI":"10.1007\/s10495-024-02040-6","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T19:10:39Z","timestamp":1733339439000},"page":"267-281","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Melatonin ameliorates inflammation and improves outcomes of ischemia\/reperfusion injury in patients undergoing coronary artery bypass grafting surgery: a randomized placebo-controlled study"],"prefix":"10.1007","volume":"30","author":[{"given":"Eman Ahmed","family":"Casper","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lamia El","family":"Wakeel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagwa A.","family":"Sabri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramy","family":"Khorshid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A.","family":"Gamal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah F.","family":"Fahmy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"2040_CR1","unstructured":"BHF (2023) British Heart Foundation Factsheet. https:\/\/www.bhforguk\/-\/media\/files\/for-professionals\/research\/heart-statistics\/bhf-cvd-statistics-global-factsheetpdf"},{"key":"2040_CR2","doi-asserted-by":"crossref","unstructured":"Raparelli V, Nocella C, Proietti M et al (2022) Testosterone-to-estradiol ratio and platelet thromboxane release in ischemic heart disease: the EVA project. 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This study also applied the CONSORT guidelines and the ICMJE recommendations. The protocol was revised and approved by the committee of ethics for experimental and clinical studies at both the Faculty of Pharmacy and Faculty of Medicine, Ain Shams University, Cairo, Egypt. ClinicalTrials.gov registration number: NCT05552586. All participants were given information sheets explaining all the details pertaining to the study. Informed consents were obtained from all patients before their inclusion in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}