Amiodarone Prophylaxis Reduces Major Cardiovascular Morbidity and Length of Stay after Cardiac Surgery: A Meta-Analysis

Aasbo, Johan D.; Lawrence, Andrew; Krishnan, K. Ranga Rama; Kim, Michael; Trohman, Richard G.

doi:10.7326/0003-4819-143-5-200509060-00008

Cited by 110 publications

(70 citation statements)

References 45 publications

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“…By 'overlapping', it is meant that any one of these meta-analyses shares some trial results with at least one other of these metaanalyses, to the extent that the estimates produced by these meta-analyses may be regarded as being to some degree not independent of one another. For meta-analyses with non-fatal endpoints, there are 23 such overlapping metaanalyses [17,19,20,[26][27][28][30][31][32][33]35,[38][39][40][41][43][44][45][46][47][48][49][50]. Therefore, there are 18 meta-analyses with fatal endpoints [49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] and 21 meta-analyses with non-fatal endpoints [15,22,25,42,[52][53]…”

Section: Resultsmentioning

confidence: 99%

Are cardiovascular trial results systematically different between North America and Europe? A study based on intra-meta-analysis comparisons

Bowater

Hartley

Lilford

2015

Archives of Cardiovascular Diseases

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There is some evidence to support the theory that, relative to controls, interventions are more favoured in cardiovascular trials conducted in Europe than in North America, when treatment efficacy is measured in terms of a non-fatal endpoint. However, the overall support for systematic differences in cardiovascular trial results between Europe and North America is weak, which may be surprising given the amount of data collected.

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Section: Resultsmentioning

confidence: 99%

Are cardiovascular trial results systematically different between North America and Europe? A study based on intra-meta-analysis comparisons

Bowater

Hartley

Lilford

2015

Archives of Cardiovascular Diseases

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“…This may also explain the absence of a positive effect on the incidence of tachyarrhythmias, although one could also argue that there are better and less invasive alternatives for preventing postoperative arrhythmias, such as ␤-blockers or amiodarone. 23 A second limitation of the study is that the median Euroscore in both groups was low, representing a relatively healthy population of cardiac surgical patients. Sicker patients are thought to benefit more from TEA, 24 but unfortunately, these patients also most often have contraindications for the application of this technique, in particular because of an impaired coagulation status.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Epidural Anesthesia for Cardiac Surgery: A Randomized Trial

et al. 2011

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Background The addition of thoracic epidural anesthesia (TEA) to general anesthesia (GA) during cardiac surgery may have a beneficial effect on clinical outcomes. TEA in cardiac surgery, however, is controversial because the insertion of an epidural catheter in patients requiring full heparinization for cardiopulmonary bypass may lead to an epidural hematoma. The clinical effects of fast-track GA plus TEA were compared with those of with fast-track GA alone. Methods A randomized controlled trial was conducted in 654 elective cardiac surgical patients who were randomly assigned to combined GA and TEA versus GA alone. Follow-up was at 30 days and 1 yr after surgery. The primary endpoint was 30-day survival free from myocardial infarction, pulmonary complications, renal failure, and stroke. Results Thirty-day survival free from myocardial infarction, pulmonary complications, renal failure, and stroke was 85.2% in the TEA group and 89.7% in the GA group (P = 0.23). At 1 yr follow-up, survival free from myocardial infarction, pulmonary complications, renal failure, and stroke was 84.6% in the TEA group and 87.2% in the GA group (P = 0.42). Postoperative pain scores were low in both groups. Conclusions This study was unable to demonstrate a clinically relevant benefit of TEA on the frequency of major complications after elective cardiac surgery, compared with fast-track cardiac anesthesia without epidural anesthesia. Given the potentially devastating complications of an epidural hematoma after insertion of an epidural catheter, it is questionable whether this procedure should be applied routinely in cardiac surgical patients who require full heparinization.

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“…Так, по данным многих рандомизированных иссле-дований, амиодарон у пациентов с исходно синусовым ритмом снижает количество периоперационных ослож-нений, в том числе ФП [18]. С целью профилактики ФП оправданы комбинации бета-блокаторов и ацетилцисте-ина [19], препаратов магния [20], статинов [21].…”

Section: Discussionunclassified

Preventive AF ablation in patients with mitral valve lesion and left atrium enlargement: 3-month follow-up results

Богачев-Прокофьев¹,

Сапегин²,

Pivkin³

et al. 2017

PKiK

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Aim. Persistence or appearance of atrial fibrillation (AF) after mitral valve surgery significantly reduces the number of excellent and good results in the long-term period. AF leads to heart failure and pulmonary hypertension and increases the risk of thromboembolic events and stroke. Drug strategies for prevention of new-onset AF in the postoperative period are well developed, while invasive methods are still under development and clinical trials. This study aims to evaluate the safety and efficacy of surgical prevention of atrial fibrillation in patients with left atrium enlargement and mitral valve (MV) lesion at 3-month follow-up. Methods. Forty patients operated in our clinic over a period of 2015–2017 were included in the study. All patients had MV lesion and left atrial dilatation greater than 60 mm. All patients had a sinus rhythm at the time of the operation and no documented AF in the history. The mean age of the patients was 48.9±10.1 (23-69 years). All patients had indications for mitral valve surgery and were randomized into two groups. The first group included patients who underwent a concomitant preventive ablation procedure (n = 20). The second group included patients with isolated MV surgery (n = 20). Complications and heart rhythm were evaluated within 3 months after surgery. Results. Patients who underwent preventive ablation within 3 months after the surgery did not differ significantly in the number of complications as compared with the control. In the group of patients with preventive ablation, a higher freedom from AF in comparison with the group of patients with isolated MV surgery was observed: 95 vs. 40%, respectively. Conclusion. Preventive atrial fibrillation ablation in patients with mitral valve lesion and left atrium enlargement is a safe and effective procedure. Preventive ablation reduces the risk of atrial fibrillation by 1.6 times within 3-month follow-up.Received 24 April 2017. Accepted 28 June 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.Author contributions Conception and study design: A.V. Bogachev-Prokophiev, A.V. Sapegin. Data collection and analysis: A.V. Sapegin, A.N. Pivkin, R.M. Sharifulin, A.V. Afanasyev, M.A. Ovcharov. Drafting the article: A.V. Sapegin. Critical revision of the article: A.V. Bogachev-Prokophiev. Final approval of the version to be published: A.V. Bogachev-Prokophiev, A.V. Sapegin, A.N. Pivkin, R.M. Sharifulin, A.V. Afanasyev, M.A. Ovcharov, A.M. Karaskov.

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Amiodarone Prophylaxis Reduces Major Cardiovascular Morbidity and Length of Stay after Cardiac Surgery: A Meta-Analysis

Cited by 110 publications

References 45 publications

Are cardiovascular trial results systematically different between North America and Europe? A study based on intra-meta-analysis comparisons

Are cardiovascular trial results systematically different between North America and Europe? A study based on intra-meta-analysis comparisons

Thoracic Epidural Anesthesia for Cardiac Surgery: A Randomized Trial

Preventive AF ablation in patients with mitral valve lesion and left atrium enlargement: 3-month follow-up results

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