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

Abstract

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.