Incidence and Outcomes of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting of a Randomized Controlled Trial: A Blinded End-of-cycle Analysis.

Autor:	Musa AF; Jeffrey Cheah School of Medicine & Health Sciences, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia.; Victorian Heart Institute, Monash University, 3168 Melbourne, Australia., Dillon J; Department of Cardiothoracic Surgery, National Heart Institute, 50400 Kuala Lumpur, Malaysia., Taib MEM; Department of Cardiothoracic Surgery, National Heart Institute, 50400 Kuala Lumpur, Malaysia., Yunus AM; Department of Cardiothoracic Surgery, National Heart Institute, 50400 Kuala Lumpur, Malaysia., Sanusi AR; Department of Cardiothoracic Surgery, National Heart Institute, 50400 Kuala Lumpur, Malaysia., Nordin MN; Department of Cardiothoracic Surgery, National Heart Institute, 50400 Kuala Lumpur, Malaysia., Smith JA; Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, 3168 Melbourne, Australia.; Department of Cardiothoracic Surgery, Monash Health, 3168 Melbourne, Australia.
Jazyk:	angličtina
Zdroj:	Reviews in cardiovascular medicine [Rev Cardiovasc Med] 2022 Apr 01; Vol. 23 (4), pp. 122. Date of Electronic Publication: 2022 Apr 01 (Print Publication: 2022).
DOI:	10.31083/j.rcm2304122
Abstrakt:	Objective: The objective of this study is to analyse the incidence of postoperative atrial fibrillation (POAF), demography, post-operative outcomes including morbidity and mortality, length of Cardiac Intensive Care Unit (CICU) stay, High Dependency Unit (HDU) stay, and total hospital stay in patients undergoing coronary bypass grafting (CABG) at Institut Jantung Negana (IJN). Methods: We conducted a prospective, randomised, controlled trial. We supplied the treatment group with Tocovid capsules and the control group with placebo containing palm superolein. Results: Since January 2019, we have recruited the target population of 250 patients. However, the result is still blinded as we are still analysing blood samples for tocotrienol levels. 89.2% of patients completed the study with a 3.6% mortality and a 7.6% attrition rate. 35.2% of the patients developed POAF, the mean time being 46.06 ± 26.96 hours post-CABG. We did not observe any statistically significant difference when we compared left atrial size, New York Heart Association (NYHA) functional class, ejection fraction and premorbid history, besides EuroSCORE II (The European System for Cardiac Operative Risk Evaluation II) status except for older age group, right atrial size, and pleural effusion. There was also no difference in bypass time, cross clamp time or number of anastomoses. However, we noted a significant difference in death ( p = 0.01) and renal failure requiring dialysis ( p = 0.007) among patients with POAF; those patients also had a longer CICU stay ( p = 0.005), HDU stay ( p = 0.02), and total hospital stay ( p = 0.001). Conclusions: POAF is associated with a higher incidence of renal failure and death while it increases CICU, HDU, and total hospital stay. It remains to be seen whether Tocovid reduces POAF and its associated sequelae. Clinical Trial Registration: NCT03807037 (Registered on 16 January 2019). Competing Interests: The authors declare no conflict of interest. (Copyright: © 2022 The Author(s). Published by IMR Press.)
Databáze:	MEDLINE
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