Objective To systematically review randomized controlled trials to compare myocardial protection profiles of sevoflurane with propofol in patients undergoing coronary artery bypass grafting （CABG） surgery. Methods Electronic databases were searched to identify all randomized controlled trials comparing sevoflurane with propofol for protecting myocardium in adult patients undergoing CABG surgery. Two authors independently extracted patients’ perioperative data

including patients’ baseline characteristics

surgical variables

and outcome data. For continuous variables

treatment effects were calculated as weighted mean difference （WMD） and 95% confidential interval （CI）. For dichotomous data

treatment effects were calculated as odds ratio （OR） and 95% CI. Each outcome was tested for heterogeneity

and randomized-effects or fixed-effects model was used in the presence or absence of significant heterogeneity （Q test P<0.05）. Sensitivity analyses were done by examining the influence of statistical model on estimated treatment effects. Publication bias was explored through visual inspection of funnel plots of the outcomes. Statistical significance was defined as P<0.05. Results Our search yielded 13 studies including 696 patients

and 402 patients were allocated into sevoflurane group and 294 into propofol group. There was no significant difference in postoperative mechanical ventilation time

inotropic support

mortality

myocardial infarction

and atrial fibrillation between the two groups （all P>0.05）. Patients randomized into sevoflurane group had higher post-bypass cardiac index （WMD=0.39

95% CI: 0.18 to 0.60

P=0.0003）

lower troponin I level （WMD=-0.82

95% CI:-0.87 to-0.85

P=0.0002）

lower incidence of myocardial ischemia （OR=0.37

95% CI: 0.16 to 0.83

P=0.02）

shorter ICU and hospital stay length （WMD=-10.99

95% CI:-12.97 to-9.01

P<0.00001; WMD=-0.78

95% CI:-1.00 to-0.56

P<0.00001

respectively）. Conclusion This meta-analysis has found some evidence showing that sevoflurane has better myocardial protection than propofol in CABG surgery.