 Both DECS and SIRS assigned patients undergoing cardiac surgery with CPB to receive either a high intraoperative dose of steroids dexamethasone 1 mgkg, or methylprednisolone 500 mg, respectively or placebo. The point estimates of both trials suggested a possible reduction in serious complications and mortality. Planned subgroup analyses in the DECS trial steroids reduced the incidence of respiratory failure 3.0 vs. 4.3, P0.02, infection 9.5 vs. 14.8, P0.009, and shortened hospital stay median 8 7-13 vs. 9 7-13 days, P0.009.6 Severe renal failure need for RRT was reduced, 0.4 vs. 1.0, P0.04.8 But SIRS found methylprednisolone was associated with a higher incidence of myocardial injury as measured by elevation of CK-MB enzyme. Nether trial identified a higher risk of myocardial infarction MI. The methylprednisolone-induced elevation of CK-MB may therefore be a class effect. 