Sole and combined vitamin C supplementation can prevent postoperative atrial fibrillation after cardiac surgery: A systematic review and meta-analysis of randomized controlled trials
Open accessAbstract
We undertook a systematic review and meta-analysis to evaluate the effect of vitamin C supplementation (vitamin C solely or as adjunct to other therapy) on prevention of postoperative atrial fibrillation (POAF) in patients after cardiac surgery. PubMed, Embase, Web of Science, and Cochrane Library were systematically searched to identify randomized controlled trials assessing the effect of vitamin C supplementation in adult patients undergoing cardiac surgery, and the meta-analysis was performed with a random-effects model. Thirteen trials involving 1956 patients were included. Pooling estimate showed a significantly reduced incidence of POAF (relative risk [RR]: 0.68, 95% confidence interval [CI]: 0.54 to 0.87, P = 0.002) both in vitamin C alone (RR: 0.75, 95% CI: 0.63 to 0.90, P = 0.002) and as an adjunct to other therapy (RR: 0.32, 95% CI: 0.20 to 0.53, P < 0.001). The results remain stable and robust in subgroup and sensitivity analyses, and trial sequential analysis also confirmed that the evidence was sufficient and conclusive. Additionally, vitamin C could significantly decrease intensive care unit length of stay (weighted mean difference: -0.24 days, 95% CI: -0.45 to -0.03, P = 0.023), hospital length of stay (weighted mean difference: -0.95 days, 95% CI: -1.64 to -0.26, P = 0.007), and risk of adverse events (RR: 0.45, 95% CI: 0.21 to 0.96, P = 0.039). Use of vitamin C alone and as adjunct to other therapy can prevent POAF in patients undergoing cardiac surgery and should be recommended for patients receiving cardiac surgery for prevention of POAF.
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The data on the effect of vitamin C on clinical outcomes in patients undergoing cardiac surgery is still insufficient to draw firm conclusions.
“The data on the effect of vitamin C on clinical outcomes in patients undergoing cardiac surgery is still insufficient to draw firm conclusions [191,192,193,194].”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [192]
The Discussion (page unavailable) says the analysis found sufficient and conclusive evidence for vitamin C’s prevention of postoperative atrial fibrillation and recommends it for patients undergoing cardiac surgery. The paper acknowledges study limitations, but its conclusion is contrary to the claim that the data are insufficient to draw firm conclusions. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredSome recent systematic reviews and meta-analyses suggested that vitamin C significantly decreased the incidence of atrial fibrillation, ventilation time, length-of-stay in the intensive care unit, and hospital length-of-stay, but it had no significant effect on in-hospital mortality or incidence of stroke, acute kidney injury, or ventricular arrhythmia in cardiac surgery patients.
“Some recent systematic reviews and meta-analyses suggested that vitamin C significantly decreased the incidence of atrial fibrillation, ventilation time, length-of-stay in the intensive care unit, and hospital length-of-stay, but it had no significant effect on in-hospital mortality or incidence of stroke, acute kidney injury, or ventricular arrhythmia in cardiac surgery patients.”
From Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination (2021) · cites this paper as [192]
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Rekhi, B. K., Kumar, P., Diksha, D., GARG, L. K., & Cathrine, P. (2024) · PARIPEX-INDIAN JOURNAL OF RESEARCH · doi:10.36106/paripex/9500798
Galali, Y., Davies, S. J., Balaky, H. H., & Jabbar, A. (2024) · Journal of university of Anbar for pure science · doi:10.37652/juaps.2023.144371.1161
- Authors
- Shi, R., Li, Z., Chen, D., Wu, Q., Zhou, X., & Tie, H.
- Affiliations
- The Affiliated Yongchuan Hospital of Chongqing Medical University (CN)
- Tongji University (CN)
- Department of Cardiothoracic Surgery the First Affiliated Hospital of Chongqing Medical University Chongqing China
- Corresponding author
- Zhou, Xiao‐Li
- Venue
- Clinical Cardiology
- Publisher
- Wiley
- Published
- 2018-05-15
- Volume
- 41
- Issue
- 6
- Pages
- 871-878
- ISSN
- 0160-9289 (ISSN-L)
- 1932-8737
- PMC
- PMC6489881
- OpenAlex
- W2795160781
- Cited by
- 51
- References
- 39
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 6 · 2023: 10 · 2022: 2 · 2021: 12 · 2020: 9 · 2019: 7 · 2018: 2
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Cardiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81700602)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Nursing › Nutrition and Dietetics › Vitamin C and Antioxidants Research
- Keywords
- vitamin C supplementation, postoperative atrial fibrillation, cardiac surgery, atrial fibrillation prevention, adjunctive therapy, ICU length of stay, length of hospital stay, adverse events
- MeSH terms
- Aged, Anti-Arrhythmia Agents, Ascorbic Acid, Atrial Fibrillation, Female, Cardiac Surgical Procedures, Humans, Length of Stay, Male, Middle Aged, Risk Factors, Time Factors, Incidence, Odds Ratio, Randomized Controlled Trials as Topic, Treatment Outcome, Dietary Supplements
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