Curcumin Not Beneficial For Reducing Inflammation, Postoperative Complications Following Elective Abdominal Aortic Aneurysm Repair

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Curcumin is the active ingredient in turmeric, a plant that is often used for its reported health-related benefits.
Curcumin is the active ingredient in turmeric, a plant that is often used for its reported health-related benefits.

Perioperative curcumin given to patients undergoing elective aortic aneurism repair did not reduce complications or affect inflammatory response of the kidneys or other organs, according to a study published in Canadian Medical Association Journal.

Researchers conducted a randomized, parallel-group, placebo-controlled trial to determine whether perioperative oral curcumin affects the inflammatory response and risk of postoperative complications after elective abdominal aortic aneurism repair. Participants were those scheduled for elective repair of abdominal aortic aneurysm as either an open or endovascular procedure at 10 academic hospitals in Canada. Patients were assigned in a 1:1 ratio to either curcumin or placebo.

Participants, healthcare providers, and data collectors were unaware of the assignment, and tablets were identical in appearance, smell, and taste. Those assigned to curcumin received 2000 mg twice per day for 2 days before the repair, 2000 mg the morning of the repair, 2000 mg on call to the operating room, 2000 mg 6 hours after the repair, and 2000 mg the morning after the repair.

Four biomarkers were used to assess various aspects of injury and inflammatory response in the kidney and other organs: postoperative concentration of urine interleukin-18 and perioperative (postoperative minus preoperative) rise in the concentration of serum creatinine, plasma N-terminal pro-brain natriuretic peptide (NT-pro-BNP) level, and plasma high-sensitivity C-reactive protein (hs-CRP). Secondary outcomes were acute kidney injury, hospital length of stay, and a total of 14 supervised clinical events within 30 days of surgery.

A total of 606 patients were assigned to receive curcumin (n=304) or placebo (n=302) from November 2011 to November 2014. Median age was 76 years, 501 (83%) were men, 591 (98%) were white, 145 (24%) had diabetes, 194 (32%) had an estimated glomerular filtration rate <60 mL/min per 1.73 m2, and 286 (47%) underwent an open procedure. For both placebo and curcumin groups, mean perioperative concentration levels of plasma NT-pro-BNP increased by 202% and levels of plasma hs-CRP increased by 1846%. Curcumin did not significantly affect any of the biomarker concentrations compared with placebo (median postoperative urine interleukin-18, 13 vs 16 pg/mL; median perioperative rise in creatinine, 1 vs 1 μmol/L; median perioperative rise in plasma NT-pro-BNP, 221 vs 184 pg/mL; median perioperative increase in plasma hs-CRP, 58 vs 58 μg/mL).

The researchers found an increased risk in acute kidney injury with curcumin vs placebo (51/304 [17%] vs 30/302 [10%]), yet they found no difference in the length of hospital stay (5 vs 5 d) or the risk of a composite of clinical events (28/304 [9%] vs 27/302 [9%]).

“In this randomized trial, the largest to date, perioperative oral curcumin did not ameliorate the complications of elective abdominal aortic aneurysm repair,” the authors conclude. “Our findings emphasize the importance of testing turmeric and curcumin in rigorous human clinical trials before espousing any health benefits, as is currently done in the popular media.”

Reference

Garg AX, Devereaux PJ, Hill A, et al; Curcumin AAA AKI Investigators. Oral curcumin in elective abdominal aortic aneurysm repair: a multicentre randomized controlled trial. CMAJ. 2018;190(43):E1273-E1280.

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