Preventative effects of bisoprolol transdermal patches on postoperative atrial fibrillation in high-risk patients undergoing non-cardiac surgery: A subanalysis of the MAMACARI study
| Autor: | Takuro Masuda, Hisatoshi Mori, Yoichiro Naito, Mamacari Investigators, Kentaro Ejiri, Kazuyoshi Shimizu, Yukiko Hikasa, Hironobu Toda, Takayuki Iwano, Kazufumi Nakamura, Toru Miyoshi, Hiroshi Morimatsu, Masashi Yoshida, Hiroshi Ito |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Transdermal patch Revised Cardiac Risk Index Transdermal Patch 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors Internal medicine Atrial Fibrillation medicine Bisoprolol Humans 030212 general & internal medicine Risk factor Stroke Aged business.industry Atrial fibrillation Perioperative medicine.disease Blood pressure Cardiology Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of cardiology. 78(5) |
| ISSN: | 1876-4738 |
| Popis: | Background Perioperative atrial fibrillation (POAF) after non-cardiac surgery is a risk factor for cardiovascular events including stroke and death. The aim of this subanalysis of the MAMACARI study, a multicenter randomized control study on the effectiveness of a bisoprolol transdermal patch for prevention of perioperative myocardial injury in high-risk patients undergoing non-cardiac surgery, was to identify the predictors of POAF after non-cardiac surgery in high-risk patients and to determine changes in blood pressure and heart rate during bisoprolol patch administration in the perioperative period. Methods and Results Patients aged over 60 years with hypertension and a high revised cardiac risk index (≥2) who were scheduled to undergo non-cardiac surgery were randomly assigned to a bisoprolol patch group (n = 120) or a control group (n = 120). We divided the patients into two groups: patients with POAF (POAF group; n = 16) and patients without POAF (non-POAF group; n = 206). Multivariate analysis showed that bisoprolol patch therapy (OR: 0.30, 95% CI: 0.092–0.978) and surgery time of 250 min or more (OR: 4.99, 95% CI: 1.37–18.2) were independently associated with POAF. Although systolic blood pressure did not differ significantly between the two groups throughout the perioperative period, treatment with a bisoprolol patch significantly reduced heart rate throughout the perioperative period compared with that in the control group. Conclusions Low dose of a bisoprolol patch in the perioperative period was effective for prevention of POAF after non-cardiac surgery in high-risk patients, while long surgery time was an independent risk factor for POAF. It is expected that low dose of a bisoprolol patch can prevent POAF without causing hypotension. |
| Databáze: | OpenAIRE |
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