Corticosteroides intravenosos no perioperatório reduzem a incidência de fibrilação atrial após cirurgia cardíaca

Abbaszadeh, Monir; Khan, Zahid Hussain; Mehrani, Fariborze; Jahanmehr, Hammid

doi:10.5935/1678-9741.20120005

Cited by 21 publications

(4 citation statements)

References 19 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Eleven studies [22,27,37,38,[45][46][47][48][49][50][51] used low-dose corticosteroids with the remaining 51 studies administered high-dose corticosteroids. There was no significant interaction between high-and low-dose corticosteroid and the incidences of myocardial or pulmonary adverse events and surgical site infection.…”

Section: Subgroup Analysesmentioning

confidence: 99%

“…A previous systematic review and meta-analysis published in 2011 found that corticosteroids were not associated with any significant reduction in clinically important adverse outcomes from heart surgery [19]. Since that review was published, 8 randomized controlled trials (RCTs) including 2 trials [20,21] with large population sample sizes have been published [20][21][22][23][24][25][26][27]. Thus, an updated systematic review and meta-analysis is warranted to summarize the current understanding of the use of corticosteroids in patients undergoing heart surgery with CPB.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The efficacy and safety of prophylactic corticosteroids for the prevention of adverse outcomes in patients undergoing heart surgery using cardiopulmonary bypass: a systematic review and meta-analysis of randomized controlled trials

Paassen

Langan

et al. 2020

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

Corticosteroids are often administered prophylactically to attenuate the inflammatory response associated with cardiac surgery using cardiopulmonary bypass (CPB). However, the efficacy and safety profile of corticosteroids remain uncertain. The primary aim of this systematic review and meta-analysis was to investigate the effect of corticosteroids on mortality in adult cardiac surgery using CPB. Secondary aims were to examine the effect of corticosteroids on myocardial adverse events, pulmonary adverse events, atrial fibrillation, surgical site infection, gastrointestinal bleeding and duration of stay in the intensive care unit and hospital. Randomized controlled trials (RCTs) were systematically searched in electronic databases (MEDLINE, EMBASE, CINAHL, CENTRAL and Web of Science) from their inception until March 2019. Observational studies, case reports, case series and literature reviews were excluded. Sixty-two studies (n = 16 457 patients) were included in this meta-analysis. There was no significant difference in mortality between the corticosteroid and placebo groups [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.81–1.14; P = 0.65, participants = 14 693, studies = 24, evidence of certainty: moderate]. Compared to those receiving a placebo, patients who were given corticosteroids had a significantly higher incidence of myocardial adverse events (OR 1.17, 95% CI 1.03–1.33; P = 0.01, participants = 14 512, studies = 23) and a lower incidence of pulmonary adverse events (OR 0.86, 95% CI 0.75–0.98; P = 0.02, participants = 13 426, studies = 17). The incidences of atrial fibrillation (OR 0.87, 95% CI 0.81–0.94; P < 0.001, participants = 14 148, studies = 24) and surgical site infection (OR 0.81, 95% CI 0.73–0.90; P < 0.001, participants = 13 946; studies = 22) were all lower in patients who were given corticosteroids. In the present meta-analysis of 62 RCTs (16 457 patients), including the 2 major RCTs (SIRS and DECS trials: 12 001 patients), we found that prophylactic corticosteroids in cardiac surgery did not reduce mortality. The clinical significance of an increase in myocardial adverse events remains unclear as the definition of a relevant myocardial end point following cardiac surgery varied greatly between RCTs.

show abstract

Section: Subgroup Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of prophylactic corticosteroids for the prevention of adverse outcomes in patients undergoing heart surgery using cardiopulmonary bypass: a systematic review and meta-analysis of randomized controlled trials

Paassen

Langan

et al. 2020

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

show abstract

“…Atrial fibrillation (AF) is a common complication after cardiac surgery, affecting about 10% to 40% of patients undergoing Coronary Artery Bypass Grafting (CABG) [ 1 - 3 ] . This arrhythmia occurs most frequently in the first five days of the postoperative period, peaking between 24 and 72 hours, being uncommon after the first week [ 3 , 4 ] .…”

Section: Introductionmentioning

confidence: 99%

Incidence of postoperative atrial fibrillation in patients undergoing on-pump and off-pump coronary artery bypass grafting

Júnior¹,

Matkovski²,

Giovanni³

et al. 2015

Revista Brasileira De Cirurgia Cardiovascular

View full text Add to dashboard Cite

ObjectiveTo determine the incidence of postoperative atrial fibrillation in patients undergoing on-pump and off-pump coronary artery bypass grafting.MethodsA retrospective study with analysis of 230 medical records between January 2011 and October 2013 was conducted.ResultsFifty-six (24.3%) out of the 230 patients were female. The average age of patients undergoing on-pump coronary artery bypass grafting was 59.91±8.62 years old, and off-pump was 57.16±9.01 years old (P=0.0213). The average EuroSCORE for the on-pump group was 3.37%±3.08% and for the off-pump group was 3.13%±3% (P=0.5468). Eighteen (13.43%) patients who underwent off-pump coronary artery bypass grafting developed postoperative atrial fibrillation, whereas for the onpump group, 19 (19.79%) developed this arrhythmia, with no significant difference between the groups (P=0.1955).ConclusionOff-pump coronary artery bypass grafting did not reduce the incidence of atrial fibrillation in the postoperative period. Important predictors of risk for the development of this arrhythmia were identified as: patients older than 70 years old and presence of atrial fibrillation in perioperative period in both groups, and non-use of beta-blockers drugs postoperatively in the on-pump group.

show abstract

“…Postoperative atrial brillation (POAF) is a common arrhythmia that occurs 15-40% after CABG and may worsen the prognosis of patients in the intensive care unit (ICU) (Abbaszadeh, Khan, et al 2012, Bohatch Júnior, Matkovski, et al 2015, Gamst, Christiansen, et al 2015. This arrhythmia occurs most commonly 1-5 days after surgery, peaks from 24 to 72 hours, and decreases within 4 to 7 days after surgery (Silva, Lima, et al 2010;Peretto, Durante, et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the effect of empagliflozin on prevention of atrial fibrillation after coronary artery bypass grafting: A double-blind, randomized, placebo-controlled trial

zarei,

Fazli,

Tayyebi

et al. 2024

Preprint

View full text Add to dashboard Cite

Purpose This study aimed to evaluate the effect of empagliflozin in preventing atrial fibrillation after coronary artery bypass grafting (CABG). Methods Eighty-two patients who fulfilled the inclusion criteria were allocated to the empagliflozin group (n = 43) or placebo group (n = 39). In two groups, patients received empagliflozin or placebo tablets three days before surgery and on the first three postoperative days (for six days) in addition to the standard regimen during hospitalization. During the first three days after surgery, types of arrhythmias after cardiac surgery, including supraventricular arrhythmias, especially postoperative atrial fibrillation (POAF), ventricular arrhythmias, and heart blocks, were assessed by electrocardiogram monitoring. C-reactive protein (CRP) levels were evaluated on the pre-operatively and postoperative third day. Results The incidence of POAF in the treatment group was lower compared to the control group; however, this reduction was statistically non-significant (p = 0.09). The frequency of ventricular tachycardia reduced significantly in the treatment group versus patients in the control (p = 0.02). Also, a significant reduction in the frequency of premature ventricular contractions (PVCs) was seen in the treatment group in comparison with the control group (p = 0.001). After the intervention, CRP levels were significantly less in the empagliflozin group in the control group in the third postoperative day (p = 0.04). Conclusion The prophylactic use of empagliflozin effectively reduced the incidence of ventricular arrhythmia in patients undergoing heart surgeries.

show abstract

Corticosteroides intravenosos no perioperatório reduzem a incidência de fibrilação atrial após cirurgia cardíaca

Cited by 21 publications

References 19 publications

The efficacy and safety of prophylactic corticosteroids for the prevention of adverse outcomes in patients undergoing heart surgery using cardiopulmonary bypass: a systematic review and meta-analysis of randomized controlled trials

The efficacy and safety of prophylactic corticosteroids for the prevention of adverse outcomes in patients undergoing heart surgery using cardiopulmonary bypass: a systematic review and meta-analysis of randomized controlled trials

Incidence of postoperative atrial fibrillation in patients undergoing on-pump and off-pump coronary artery bypass grafting

Evaluation of the effect of empagliflozin on prevention of atrial fibrillation after coronary artery bypass grafting: A double-blind, randomized, placebo-controlled trial

Contact Info

Product

Resources

About