Milrinone Use Is Associated With Postoperative Atrial Fibrillation After Cardiac Surgery

Abstract

Background-Postoperative atrial fibrillation (AF), a frequent complication after cardiac surgery, causes morbidity and prolongs hospitalization.

The influence of preoperative pharmacotherapy on the appearance of postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting

“…28,29,30,31,32 Andrews et al showed that the incidence of POAF decreased from 34% to 8, 7% in patients received beta-blockers. In another meta-analysis of Kowey et al, the decrease in incidence of AF was from 20% to 8, 7%.…”

Risk factors of atrial fibrillation following off-pump coronary artery bypass graft surgery: predictive value of C-reactive protein and transfusion requirement

“…The finding that vasopressor therapy, and not inotropic therapy, was an independent predictor is also somewhat contradictory. The inotropic agent used in this study was milrinone, which was demonstrated to be a strong independent risk factor of postoperative AF following cardiac surgery [25]. The vasopressor used in this study was norepinephrine in doses not exceeding 0.3 mg kg À1 min À1 .…”

The role of milrinone in children with cardiovascular compromise: review of the literature

“…In multivariable logistic regression, age (p < 0.001), ejection fraction (p ¼ 0.02), and milrinone use (odds ratio, 4.86; 95% confidence interval, 2.31-10.25; p < 0.001) independently predicted postoperative AF. Although the use of milrinone was not directly linked to mortality, patients who developed AF stayed in the hospital longer (p < 0.001) and were more likely to die (p ¼ 0.02) [13]. However, atrial fibrillation is very rare in children, and in particular its occurrence has not been associated with the use of milrinone in children.…”

“…Of interest, in a recent study by Fleming et al the use of milrinone was associated with an increased risk of postoperative atrial fibrillation after cardiac surgery in adults (58.2% versus 26.1% in nonusers; p < 0.001) [13]. In multivariable logistic regression, age (p < 0.001), ejection fraction (p ¼ 0.02), and milrinone use (odds ratio, 4.86; 95% confidence interval, 2.31-10.25; p < 0.001) independently predicted postoperative AF.…”