The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.
Interventions on Prevention of Postoperative Atrial Fibrillation in Patients Undergoing Heart Surgery: A Meta-Analysis
Abstract
Background — Postoperative atrial fibrillation (AF) is a common complication of cardiac surgery and has been associated with increased incidence of other complications and increased hospital length of stay (LOS). Prevention of AF is a reasonable clinical goal, and, consequently, many randomized trials have evaluated the effectiveness of pharmacological and nonpharmacological interventions for prevention of AF. To better understand the role of various prophylactic therapies against postoperative AF, a systematic review of evidence from randomized trials was performed. Methods and Results — Fifty-two randomized trials (controlled by placebo or routine treatment) of β-blockers, sotalol, amiodarone, or pacing were identified by systematic literature search. The 3 drug treatments each prevented AF with the following odds ratios (ORs): β-blockers, 0.39 (95% CI, 0.28 to 0.52); sotalol, 0.35 (95% CI, 0.26 to 0.49); and amiodarone, 0.48 (95% CI, 0.37 to 0.61). Pacing was also effective; for biatrial pacing, the OR was 0.46 (95% CI, 0.30 to 0.71). The influence of pharmacological interventions on LOS was as follows: −0.66 day (95% CI, 2.04 to 0.72) for β-blockers; −0.40 day (95% CI, 0.87 to 0.08) for sotalol; and −0.91 day (95% CI, 1.59 to −0.23) for amiodarone. The influence for biatrial pacing was −1.54 day (95% CI, −2.85 to −0.24). The incidence of stroke was 1.2% in all the treatment groups combined and 1.4% in controls (OR, 0.90; 95% CI, 0.46 to 1.74). Conclusions — β-Blockers, sotalol, and amiodarone all reduce risk of postoperative AF with no marked difference between them. There is evidence that use of these drugs will reduce LOS. Biatrial pacing is a promising new treatment opportunity. There was no evidence that reducing postoperative AF reduces stroke; however, data on stroke are incomplete.
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Cites
ACC/AHA guidelines for coronary artery bypass graft surgery
Eagle, K. A., Guyton, R. A., Davidoff, R., Ewy, G. A., Fonger, J., Gardner, T. J., Gott, J. P., Herrmann, H. C., Marlow, R. A., Nugent, W. C., et al. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00389-7 · Cited by 1,995
Self-citationAdverse Cerebral Outcomes after Coronary Bypass Surgery
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Hazards of postoperative atrial arrhythmias
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Preoperative Amiodarone as Prophylaxis against Atrial Fibrillation after Heart Surgery
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Atrial Arrhythmias after Cardiothoracic Surgery
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2018 ESC/EACTS guidelines on myocardial revascularization
Neumann, F.-J., Sousa-Uva, M., Ahlsson, A., Alfonso, F., Banning, A. P., Benedetto, U., Byrne, R. A., Collet, J.-P., Falk, V., Head, S. J., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehy394 · Cited by 7,167
2018 ESC/EACTS Guidelines on myocardial revascularization
Neumann, F.-J., Sousa-Uva, M., Ahlsson, A., Alfonso, F., Banning, A. P., Benedetto, U., Byrne, R. A., Collet, J.-P., Falk, V., Head, S. J., et al. (2019) · EuroIntervention · doi:10.4244/eijy19m01_01 · Cited by 1,259
2018 ESC/EACTS Guidelines on myocardial revascularization
Sousa-Uva, M., Neumann, F.-J., Ahlsson, A., Alfonso, F., Banning, A. P., Benedetto, U., Byrne, R. A., Collet, J.-P., Falk, V., Head, S. J., et al. (2019) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezy289 · Cited by 989
Fuster, V., Rydén, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Kay, G. N., Le Huezey, J.-Y., Lowe, J. E., et al. (2011) · Circulation · doi:10.1161/cir.0b013e318214876d · Cited by 859
Impact of allocation concealment on conclusions drawn from meta-analyses of randomized trials
Pildal, J., Hrobjartsson, A., Jorgensen, K., Hilden, J., Altman, D., & Gotzsche, P. (2007) · International Journal of Epidemiology · doi:10.1093/ije/dym087 · Cited by 472
Metadata
- Authors
- Crystal, E., Connolly, S. J., Sleik, K., Ginger, T. J., & Yusuf, S.
- Venue
- Circulation
- Published
- 2002-07-02
- Volume
- 106
- Issue
- 1
- Pages
- 75-80
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2052154644
- Cited by
- 490
- References
- 37
- FWCI
- 18.06
- Type
- journal article
- Language
- en
- Open access
- closed
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- Crystal, E., Connolly, S. J., Sleik, K., Ginger, T. J., & Yusuf, S. (2002). Interventions on Prevention of Postoperative Atrial Fibrillation in Patients Undergoing Heart Surgery: A Meta-Analysis. Circulation. https://doi.org/10.1161/01.cir.0000021113.44111.3e
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