The effect of omega-3 polyunsaturated fatty acids in prevention of postoperative atrial fibrillation development in patients undergoing coronary artery bypass graft surgery

Abstract

Funding Acknowledgements Type of funding sources: None. Purpose. To estimate the effect of omega-3 polyunsaturated fatty acids (PUFAs) in prevention of postoperative atrial fibrillation (POAF) in patients with coronary artery disease undergoing coronary artery bypass graft (CABG) surgery. Methods. Studied were 306 patients who underwent CABG. All the patients were divided into two groups depending on the prescription of omega-3 PUFAs in the pre- and postoperative period by randomization method: 1 group comprised 158 patients without PUFAs (82.7% men, median age 63.0 (57.0;67.0) years, 2 group - 148 patients with PUFAs (89.3% men, median age 60.0 (57.0;64.0) years). PUFAs were prescribed 2000 mg daily starting with 5 days before CABG and 1000 mg daily after CABG for 21 days. In all the patients, we studied interleukin (IL)-6, IL-8, IL-10, NT-proBNP, troponin, superoxide dismutase (SOD), malondialdehyde (MDA), glutathione and omega-3 index. Results. During the observation period POAF occurred in 29.7% patients of group 1, and in 16.9% patients of group 2 (p = 0.009). In postoperative period patients of group 1 had median IL-6 level 39.3% higher (p = 0.001) and median IL-10 level - 20.2% higher (p = 0.01) comparing with group 2. In patients of group 2 we found SOD median level 78.9% lower (р<0.0001) and MDA median level 33.8% lower compared to the patients of group 1 (р=0.03). In postoperative period in group 2 the median level of docosahexaenoic acid was 55% higher (p = 0.03), and omega-3 index - 43.4% higher (h = 0.04) compared with group 1. Conclusion. We found that patients with PUFAs had less activation of inflammation and oxidative stress after CABG than patients without PUFAs. The patients with PUFAs also had increased levels of docosahexaenoic acids and omega-3 index compared to the patients without PUFAs. We also found a significant decrease of the prevalence of POAF after CABG in patients with PUFAs.

Omega-3 polyunsaturated fatty acids in the prevention of postoperative atrial fibrillation in open heart surgery: a systematic review and meta-analysis

“…Наши результаты согласуются с предшествующими сведениями с литературными источниками [22]. Важное отличие нашего систематического обзоравключение отечественных научных работ [18][19][20][21]. С другой стороны, отечественные публикации по изучению влияния омега-3 ПНЖК на предотвращение ПОФП показали высокий риск систематических ошибок, что послужило причиной невключения данных источников в метаанализ.…”

“…Отечественные публикации также демонстрируют положительное воздействие омега-3 ПНЖК в снижении риска ПОФП, что по результатам работы приводит к уменьшению выраженности гемодинамических нарушений и продолжительности пребывания пациентов в стационаре [18][19][20][21]. Кроме того, исследование Рубаненко О. А. и др.…”

“…Оценка включенных исследований РКИ показала, что 4 работы ввиду высокого риска систематических ошибок не могут использоваться для метаанализа, вследствие чего они были исключены [18][19][20][21]. Для оставшихся исследований дизайн, методология их проведения и характеристики пациентов соответствовали цели настоящего исследования.…”

Incidence and Outcomes of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting of a Randomized Controlled Trial: A Blinded End-of-cycle Analysis

“…PUFAs have been demonstrated to reduce cardiovascular morbidity in animal models [ 105 ]. In a study by Rubanenko O and Rubanenko A [ 106 ], patients treated with PUFAs not only displayed reduced in inflammation and oxidative stress after CABG, but also exhibited a reduction in POAF after CABG. A meta-analysis [ 107 ] of 19 randomised controlled trials (RCTs) conducted in 2017 and a meta-analysis [ 108 ] in 2018 that included 14 RCTs also showed that CABG patients treated with PUFAs displayed a significant reduction of POAF compared to controls.…”