Effectiveness of Dexamethasone in Reducing Arrhythmia in Patients Undergoing Coronary Artery Bypass Grafting.

Autor:	Kharimantara Nakamura N; Adult Cardiac Surgery, National Cardiovascular Center Harapan Kita, Jakarta, IDN., Arman Hanafy D; Adult Cardiac Surgery, National Cardiovascular Center Harapan Kita, Jakarta, IDN., Feline Husen T; Adult Cardiac Surgery, Faculty of Medicine, University of Indonesia, Jakarta, IDN., Pipphali Vidya A; Adult Cardiac Surgery, Faculty of Medicine, University of Indonesia, Jakarta, IDN., Tony Lopolisa A; Adult Cardiac Surgery, National Cardiovascular Center Harapan Kita, Jakarta, IDN., Sugisman; Adult Cardiac Surgery, National Cardiovascular Center Harapan Kita, Jakarta, IDN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 17; Vol. 16 (10), pp. e71746. Date of Electronic Publication: 2024 Oct 17 (Print Publication: 2024).
DOI:	10.7759/cureus.71746
Abstrakt:	Introduction Coronary artery bypass grafting (CABG) carries the risk of postoperative arrhythmias. Our study focusses on the efficacy of dexamethasone in both on-pump CABG (ONCAB) and off-pump CABG (OPCAB). Methods This single center randomized control trial was conducted from July 1st, 2018 to January 20th, 2019 in patients undergoing conventional ONCAB and OPCAB at the National Cardiovascular Center Harapan Kita (NCCHK). All arrhythmia incidents were recorded postoperatively with routine monitoring done every hour until the patient was discharged. Results One hundred and twenty patients were included in the study and arrhythmias occurred in 24.2% of patients. In the ONCAB groups, there was an association between dexamethasone versus placebo in reducing the incidence of arrhythmias (p = 0.02; OR 0.23 [0.064-0.831]). However, in patients who underwent OPCAB, there was no association between dexamethasone administration and the incidence of arrhythmias (p = 0.347; OR 0.55 [0.157-1.931]). Patients on dexamethasone in both ONCAB and OPCAB groups showed a significant decrease in IL-6, CRP, and procalcitonin (p = 0.001 for all). Overall, arrhythmic subjects had significantly higher levels of inflammatory markers IL-6 (p = 0.013), CRP (p = 0.025), and procalcitonin (p = 0.001). Conclusion Dexamethasone reduced postoperative arrhythmias, likely by modulating systemic inflammation, as shown by the decrease in inflammatory markers in ONCAB patients compared to those given a placebo. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. National Cardiovascular Center Harapan Kita issued approval LBB.01.01/VII/239/KEP.050/2018. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Kharimantara Nakamura et al.)
Databáze:	MEDLINE
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