Using MPH hemostatic powder for post-procedural hemostasis was shown to result in a significant reduction in the rate of overall post-procedural complications (a composite endpoint of hematoma and infections), and a trend in reduction of the infections rates and device implantation site hematoma rates.
Background:
Due to the population aging, atrial fibrillation (AF) is becoming a more prevalent disease, it also commonly presents as a cardiac surgery complication. Randomized controlled trials (RCT) concerning anti-oxidant vitamins for atrial fibrillation (AF) prophylaxis have yielded inconsistent outcomes. Similar inconsistencies were found in other cardiovascular studies, as the HOPE and FATS studies, suggesting that vitamin E in special may not be helpful, perhaps harmful.
Methods:
All randomized controlled trials on anti-oxidant vitamins supplementation for atrial fibrillation prevention for patients undergoing cardiac surgery were sought in Medline and Cochrane databases during May 2012. Data was extracted by 3 reviewers.
Results:
Seven studies were found, three with vitamin C, two with Vitamin E and two combining both. We found an overall significant 60% decrease in the overall chance for AF occurrence mostly driven by (Figures1A and 1B) as the studies with vitamin E or vitamin C and E combined (Figures 1 C and 1D) did not show a statistically significant difference. When all studies with Vitamin E alone or in combination with Vitamin C (Figure 1E).
Conclusions:
Vitamin C supplementation decreases the incidence of post cardiac surgery AF but the data on Vitamin E is inconsistent, it may even decrease the Vitamin C benefit. As vitamin self-supplementation is extremely common in the US, large trials are extremely important not only for benefit confirmation but to exclude potential harms.
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