Postoperative Treatment of Carvedilol Following Low Dose Landiolol has Preventive Effect for Atrial Fibrillation after Coronary Artery Bypass Grafting

Yoshioka, Ichiro; Sakurai, Masahiro; Namai, Asako; Kawamura, Takae

doi:10.1055/s-0029-1186069

Cited by 16 publications

(11 citation statements)

References 17 publications

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“…The sample size of these studies ranged from 53 to 207 (total 765). Four studies in this meta-analysis enrolled patients undergoing coronary artery bypass grafting (CABG) only [15]–[18]. The remaining two included patients undergoing CABG and/or valve surgery [14], [19].…”

Section: Resultsmentioning

confidence: 99%

“…Carvedilol was administered orally by different regimens and formulations. Timing of initiation for carvedilol prophylaxis was 3–10 days before the surgery in the preoperative prophylaxis studies [15], [16], [19] and within 24 hours of surgery in the postoperative group [17], [18]. Definition of POAF in terms of duration varied among the studies.…”

Section: Resultsmentioning

confidence: 99%

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

Wang

Yin

2014

PLoS ONE

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BackgroundPostoperative atrial fibrillation (POAF) remains the most common complication after cardiac surgery. Current guidelines recommend β-blockers to prevent POAF. Carvedilol is a non-selective β-adrenergic blocker with anti-inflammatory, antioxidant, and multiple cationic channel blocking properties. These unique properties of carvedilol have generated interest in its use as a prophylaxis for POAF.ObjectiveTo investigate the efficacy of carvedilol in preventing POAF.MethodsPubMed from the inception to September 2013 was searched for studies assessing the effect of carvedilol on POAF occurrence. Pooled relative risk (RR) with 95% confidence interval (CI) was calculated using random- or fixed-effect models when appropriate. Six comparative trials (three randomized controlled trials and three nonrandomized controlled trials) including 765 participants met the inclusion criteria.ResultsCarvedilol was associated with a significant reduction in POAF (relative risk [RR] 0.49, 95% confidence interval [CI] 0.37 to 0.64, p<0.001). Subgroup analyses yielded similar results. In a subgroup analysis, carvedilol appeared to be superior to metoprolol for the prevention of POAF (RR 0.51, 95% CI 0.37 to 0.70, p<0.001). No evidence of heterogeneity was observed.ConclusionsIn conclusion, carvedilol may effectively reduce the incidence of POAF in patients undergoing cardiac surgery. It appeared to be superior to metoprolol. A large-scale, well-designed randomized controlled trial is needed to conclusively answer the question regarding the utility of carvedilol in the prevention of POAF.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

Wang

Yin

2014

PLoS ONE

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“…Landiolol was not assessed in our study; but in other studies, landiolol has demonstrated an enhanced protective effect against tachycardia during AF in post-CABG patients. 11 Another study demonstrated that in post-CABG patients, therapeutic landiolol in ''low doses'' can decrease the prevalence of AF. 12 However, our study did not demonstrate any difference regarding the incidence or prevalence of arrhythmias or postoperative 6-month mortality.…”

Section: Discussionmentioning

confidence: 99%

Carvedilol Compared With Metoprolol on Left Ventricular Ejection Fraction After Coronary Artery Bypass Graft

Shahzamani¹,

Ghanavati²,

Froutagheh³

et al. 2011

Journal of PeriAnesthesia Nursing

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“…The utility of landiolol for preventing postoperative AF has been reported widely, [6][7][8] but this is the fi rst prospective randomized trial of postoperative landiolol and the dose (0.5 to 2 μg/kg/min) is the lowest for postoperative prophylactic administration. The ideal approach is to prevent postoperative AF without worsening hemodynamics, and this was achieved with ultra-low dose landiolol administration in this study.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Atrial Fibrillation with Ultra-Low Dose Landiolol after Off-Pump Coronary Artery Bypass Grafting

Nagaoka

Arai

Tamura

et al. 2014

ATCS

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Purpose: Postoperative atrial fi brillation (AF) is a common complication of cardiac surgery that is associated with an increased incidence of other complications. The goal of this prospective randomized study was to evaluate the effect of ultra-low dose landiolol hydrochloride for prevention of AF after off-pump coronary artery bypass grafting (CABG). Methods: The subjects were 47 patients who underwent isolated CABG and were randomly divided into those who received landiolol from ICU admission until the beginning of oral drug intake (Group L) and those administered diltiazem hydrochloride over the same period (Group D). The incidence of AF within one week after surgery was examined as the primary endpoint. Heart rate, blood pressure, cardiac output, and other hemodynamic parameters were used as secondary endpoints. The rates of adverse events were also recorded. Results: The incidences of AF in the fi rst postoperative week were 4.8% and 27% in Groups L and D, respectively (p = 0.046). There were no differences in hemodynamic parameters between the Groups. In multivariate analysis, no factor emerged as a significant risk factor for postoperative AF. Two patients had adverse events of asthma and hypotension, respectively, in Group L. Conclusion: Ultra-low dose landiolol is effective for preventing AF after CABG without worsening hemodynamics.

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Postoperative Treatment of Carvedilol Following Low Dose Landiolol has Preventive Effect for Atrial Fibrillation after Coronary Artery Bypass Grafting

Abstract: Postoperative treatment with carvedilol following landiolol has the effect of preventing tachycardia during AF after coronary artery bypass grafting.

Cited by 16 publications

References 17 publications

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

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

Carvedilol Compared With Metoprolol on Left Ventricular Ejection Fraction After Coronary Artery Bypass Graft

Prevention of Atrial Fibrillation with Ultra-Low Dose Landiolol after Off-Pump Coronary Artery Bypass Grafting

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