The combination of propranolol and magnesium does not prevent postoperative atrial fibrillation

Solomon, Allen J.; Berger, Alan K.; Trivedi, Ketan K; Hannan, Robert L.; Katz, Nevin M.

doi:10.1016/s0003-4975(99)01187-x

Cited by 53 publications

(36 citation statements)

References 18 publications

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“…Postoperative AF usually occurs 24-96 h after surgery, with a peak incidence on the second postoperative day. 5, 14 In the present study, a strong positive correlation was detected between the timing of postoperative AF and maximum postoperative BS. This supports the theory that hyperglycemia induces AF.…”

Section: Bs and Af Occurrencesupporting

confidence: 66%

Postoperative Hyperglycemia and Atrial Fibrillation After Coronary Artery Bypass Graft Surgery

Tatsuishi

Adachi

Murata

et al. 2014

Circ J

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Section: Bs and Af Occurrencesupporting

confidence: 66%

Postoperative Hyperglycemia and Atrial Fibrillation After Coronary Artery Bypass Graft Surgery

Tatsuishi

Adachi

Murata

et al. 2014

Circ J

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“…One study was excluded because of duplicate publication [24]. Thus, a total of 5 studies were included in this meta-analysis [19-23]. The publication dates spanned from 2000 to 2009.…”

Section: Resultsmentioning

confidence: 99%

“…The patient and study characteristics are shown in Tables 2 and 3, respectively. Most studies reported that magnesium in addition to beta-blocker had non-significant prevention of postoperative AA after CABG [19,21-23]. But one study showed that this strategy could significantly decrease the incidence of AF after CABG [20].…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting

Wang

Zhu

et al. 2013

BMC Cardiovasc Disord

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BackgroundAtrial arrhythmia (AA) is the most common complication after coronary artery bypass grafting (CABG). Only beta-blockers and amiodarone have been convincingly shown to decrease its incidence. The effectiveness of magnesium on this complication is still controversial. This meta-analysis was performed to evaluate the effect of magnesium as a sole or adjuvant agent in addition to beta-blocker on suppressing postoperative AA after CABG.MethodsWe searched the PubMed, Medline, ISI Web of Knowledge, Cochrane library databases and online clinical trial database up to May 2012. We used random effects model when there was significant heterogeneity between trials and fixed effects model when heterogeneity was negligible.ResultsFive randomized controlled trials were identified, enrolling a total of 1251 patients. The combination of magnesium and beta-blocker did not significantly decrease the incidence of postoperative AA after CABG versus beta-blocker alone (odds ratio (OR) 1.12, 95% confidence interval (CI) 0.86-1.47, P = 0.40). Magnesium in addition to beta-blocker did not significantly affect LOS (weighted mean difference −0.14 days of stay, 95% CI −0.58 to 0.29, P = 0.24) or the overall mortality (OR 0.59, 95% CI 0.08-4.56, P = 0.62). However the risk of postoperative adverse events was higher in the combination of magnesium and beta-blocker group than beta-blocker alone (OR 2.80, 95% CI 1.66-4.71, P = 0.0001).ConclusionsThis meta-analysis offers the more definitive evidence against the prophylactic administration of intravenous magnesium for prevention of AA after CABG when beta-blockers are routinely administered, and shows an association with more adverse events in those people who received magnesium.

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“…It generally occurs between 24 and 96 h postoperatively, with a peak incidence on the second postoperative day [1-3]. With continuous electrocardiographic monitoring, the incidence of atrial fibrillation after CABG reported in previous studies varies from 10% to 50% [1,2,4], and this incidence has not decreased despite improvements in anesthetic and surgical techniques [5,6]. Furthermore, atrial fibrillation potentially leads to complications, including stroke [7-9], extended duration of hospitalization [7-10], and increasing costs [1,9,10].…”

Section: Introductionmentioning

confidence: 99%

Intravenous magnesium prevents atrial fibrillation after coronary artery bypass grafting: a meta-analysis of 7 double-blind, placebo-controlled, randomized clinical trials

Wang

et al. 2012

Trials

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BackgroundPostoperative atrial fibrillation (POAF) is the most common complication after coronary artery bypass grafting (CABG). The preventive effect of magnesium on POAF is not well known. This meta-analysis was undertaken to assess the efficacy of intravenous magnesium on the prevention of POAF after CABG.MethodsEligible studies were identified from electronic databases (Medline, Embase, and the Cochrane Library). The primary outcome measure was the incidence of POAF. The meta-analysis was performed with the fixed-effect model or random-effect model according to heterogeneity.ResultsSeven double-blind, placebo-controlled, randomized clinical trials met the inclusion criteria including 1,028 participants. The pooled results showed that intravenous magnesium reduced the incidence of POAF by 36% (RR 0.64; 95% confidence interval (CI) 0.50-0.83; P = 0.001; with no heterogeneity between trials (heterogeneity P = 0.8, I2 = 0%)).ConclusionsThis meta-analysis indicates that intravenous magnesium significantly reduces the incidence of POAF after CABG. This finding encourages the use of intravenous magnesium as an alternative to prevent POAF after CABG. But more high quality randomized clinical trials are still need to confirm the safety.

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The combination of propranolol and magnesium does not prevent postoperative atrial fibrillation

Cited by 53 publications

References 18 publications

Postoperative Hyperglycemia and Atrial Fibrillation After Coronary Artery Bypass Graft Surgery

Postoperative Hyperglycemia and Atrial Fibrillation After Coronary Artery Bypass Graft Surgery

Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting

Intravenous magnesium prevents atrial fibrillation after coronary artery bypass grafting: a meta-analysis of 7 double-blind, placebo-controlled, randomized clinical trials

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