Carvedilol for Prevention of Atrial Fibrillation after Cardiac Surgery: A Meta-Analysis

Wang, Huishan; Wang, Zeng-Wei; Yin, Zhihua

doi:10.1371/journal.pone.0094005

Cited by 21 publications

(12 citation statements)

References 29 publications

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“…β-Blockers effectively prevent postoperative AF, the most common complication of cardiac surgery. Robust meta-analyses of RCTs found a risk reduction of AF after cardiac surgery of 66–74% with β-blockers [ 75 – 78 ]. Advantages of perioperative use of β-blockers in non-cardiac surgery are less clear.…”

Section: β-Blockers In Atrial Fibrillationmentioning

confidence: 99%

The Real Role of β-Blockers in Daily Cardiovascular Therapy

Dézsi

Szentes

2017

Am J Cardiovasc Drugs

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The role of β-adrenoceptor antagonists (β-blockers) in cardiovascular therapy has been subject to diverse trends and changes over the decades. With the advent of a wide variety of excellent drugs for the treatment of antihypertension, β-blockers have been relegated from the first-line treatment of essential hypertension. However, they remain the drugs of first choice in recommendations from the respective medical societies for heart failure, coronary artery disease, and atrial fibrillation as well as in hypertension complicated with heart failure, angina pectoris, or prior myocardial infarction. When indicated, cardioselective β-blockers should be prescribed in patients with diabetes mellitus or chronic obstructive pulmonary disease. We review the available evidence for the use of β-blockers in clinical conditions in which recommendations can be made for everyday practice.

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Section: β-Blockers In Atrial Fibrillationmentioning

confidence: 99%

The Real Role of β-Blockers in Daily Cardiovascular Therapy

Dézsi

Szentes

2017

Am J Cardiovasc Drugs

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“…These findings imply that consideration of α1-AR-mediated signaling may also be important in the management of AF. Along the same lines, a recent report showed that the α, β-blocker carvedilol is more useful than the β1 selective blocker metoprolol in preventing AF after cardiac surgery [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Norepinephrine-Induced Adrenergic Activation Strikingly Increased the Atrial Fibrillation Duration through β1- and α1-Adrenergic Receptor-Mediated Signaling in Mice

et al. 2015

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BackgroundAtrial fibrillation (AF) is the most common arrhythmias among old people. It causes serious long-term health problems affecting the quality of life. It has been suggested that the autonomic nervous system is involved in the onset and maintenance of AF in human. However, investigation of its pathogenesis and potential treatment has been hampered by the lack of suitable AF models in experimental animals.ObjectivesOur aim was to establish a long-lasting AF model in mice. We also investigated the role of adrenergic receptor (AR) subtypes, which may be involved in the onset and duration of AF.Methods and ResultsTrans-esophageal atrial burst pacing in mice could induce AF, as previously shown, but with only a short duration (29.0±8.1 sec). We found that adrenergic activation by intraperitoneal norepinephrine (NE) injection strikingly increased the AF duration. It increased the duration to more than 10 minutes, i.e., by more than 20-fold (656.2±104.8 sec; P<0.001). In this model, a prior injection of a specific β1-AR blocker metoprolol and an α1-AR blocker prazosin both significantly attenuated NE-induced elongation of AF. To further explore the mechanisms underlying these receptors’ effects on AF, we assessed the SR Ca2+ leak, a major trigger of AF, and consequent spontaneous SR Ca2+ release (SCR) in atrial myocytes. Consistent with the results of our in-vivo experiments, both metoprolol and prazosin significantly inhibited the NE-induced SR Ca2+ leak and SCR. These findings suggest that both β1-AR　and α1-AR may play important roles in the development of AF.ConclusionsWe have established a long-lasting AF model in mice induced by adrenergic activation, which will be valuable in future AF study using experimental animals, such as transgenic mice. We also revealed the important role of β1- and α1-AR-mediated signaling in the development of AF through in-vivo and in-vitro experiments.

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“…Also, beta-blockers are recommended for the prevention of atrial fibrillation in patients with hypertrophic cardiomyopathy. The AHA guidelines recommend the use of beta-blockers to control the ventricular rate in patients with heart failure and acute coronary syndrome, without high risks of cardiogenic shock (55).…”

Section: Beta-blockers and Heart Rate Controlmentioning

confidence: 99%

Beta-blockers in Cardiovascular Therapy: A Review

Diaconu¹,

Marcu²,

Bratu³

et al. 2019

JMMS

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The role of beta-adrenergic receptor antagonists in cardiovascular therapy has been the subject of various studies over time, these agents representing one of the oldest class of drugs used for the treatment of cardiovascular diseases. Although beta-blockers have been excluded from guidelines as the first-line therapy in essential hypertension, they remain the first choice in patients with heart failure, coronary artery disease, and atrial fibrillation. In this article, we review the major clinical evidence for the use of beta-blockers in cardiovascular diseases. Several trials have demonstrated that beta-blockers reduce mortality in patients with heart failure with a reduced ejection fraction. Also, beta-blockers have beneficial properties in patients with heart failure with preserved ejection fraction. Guidelines recommend beta-blockers for the relief of symptoms in cases of angina pectoris and for the control of the ventricular rate in cases of atrial fibrillation. Also, beta-blockers have numerous benefits in hypertensive patients with diabetes mellitus. In conclusion, betablockers are an important class of cardiovascular drugs, reducing the mortality and morbidity rates in patients with cardiovascular diseases.

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Carvedilol for Prevention of Atrial Fibrillation after Cardiac Surgery: A Meta-Analysis

Cited by 21 publications

References 29 publications

The Real Role of β-Blockers in Daily Cardiovascular Therapy

The Real Role of β-Blockers in Daily Cardiovascular Therapy

Norepinephrine-Induced Adrenergic Activation Strikingly Increased the Atrial Fibrillation Duration through β1- and α1-Adrenergic Receptor-Mediated Signaling in Mice

Beta-blockers in Cardiovascular Therapy: A Review

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