Combination of sotalol and magnesium prevents atrial fibrillation after coronary artery bypass grafting

Intravenous magnesium sulphate and sotalol for prevention of atrial fibrillation after coronary artery bypass surgery: a systematic review and economic evaluation

“…When the analysis was restricted to the two RCTs that were judged to have adequately concealed random allocation 16,28 ( Table 2), the intervention effect was no longer statistically significant (OR = 0.84, 95% CI 0.57 to 1.26, test for overall effect p = 0.40), although heterogeneity was absent (I 2 = 0%) and no longer significant (p = 0.92). A similar pattern was evident when analyses were restricted to the three RCTs whose randomisation procedures were judged to be adequate 15,20,21,29 (Table 2) or the five RCTs whose blinding was considered adequate 13,15,17,18,24,27 (forest plots not shown). Given that the number of studies meeting the criteria of methodological adequacy for these attributes was comparatively low, these results should be interpreted with caution.…”

“…Of these initial 206 papers, 158 were excluded on screening of titles and abstracts and a further 26 were subsequently excluded on screening of the full papers (Appendix 4). The remaining 22 papers that met the inclusion criteria for this review comprised 17 that reported parallel-group RCTs (15 trials altogether) [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] and five systematic reviews.…”

“…In nine trials the comparator was explicitly reported as a placebo group, whereas in six trials it was referred to as a control group. One of the trials, by Forlani and colleagues, 20,21 compared magnesium and sotalol in combination with a control group, and against magnesium alone and sotalol alone ( Table 1). According to the authors the study was not designed to compare magnesium against sotalol directly, and no statistical tests were reported for the comparison of the two drugs.…”

“…20,21 However, the trial was designed to compare the clinical efficacy of combined sotalol and intravenous magnesium against the two agents separately, and against a control. No statistical tests were performed for the comparison between sotalol and intravenous magnesium.…”

“…The clinical effectiveness of magnesium sulphate and sotalol combination therapy has been evaluated in RCTs, although it is outside the scope of the current review. 20,21,64 This would be a worthwhile topic for future evidence synthesis.…”