Takashi Nojiri1, Kazuhiro Yamamoto2, Hajime Maeda3, Yukiyasu Takeuchi3, Naoko Ose3, Yoshiyuki Susaki3, Masayoshi Inoue4, Meinoshin Okumura4. 1. Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Osaka; Department of Biochemistry, Research Institute, National Cerebral and Cardiovascular Center, Osaka; Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka. Electronic address: nojirit@thoracic.med.osaka-u.ac.jp. 2. Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Tottori, Japan. 3. Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Osaka. 4. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka.
Abstract
BACKGROUND: We previously reported that patients with elevated preoperative B-type natriuretic peptide (BNP) levels have an increased risk for postoperative atrial fibrillation following lung cancer surgery. The present study evaluated whether the specific phosphodiesterase III inhibitor olprinone can reduce the incidence of postoperative atrial fibrillation in patients with elevated BNP levels undergoing pulmonary resection for lung cancer. METHODS: A prospective randomized study was conducted with 40 patients who had elevated preoperative BNP levels (≥ 30 pg/mL) and underwent scheduled lung cancer surgery. All patients were in sinus rhythm at surgery. Low-dose olprinone or placebo was continuously infused for 24 h and started just before anesthesia induction. The primary end point was the incidence of postoperative atrial fibrillation. The secondary end points were perioperative hemodynamics and levels of BNP, WBC counts, and C-reactive protein. RESULTS: The incidence of postoperative atrial fibrillation was significantly lower in the olprinone group than in the placebo group (10% vs 60%, P < .001). Patients in the olprinone group showed significantly lower BNP, WBC counts, and C-reactive protein levels after surgery. CONCLUSIONS: Continuous infusion of olprinone during lung cancer surgery was safe and reduced the incidence of postoperative atrial fibrillation following pulmonary resection in patients with elevated preoperative BNP levels. TRIAL REGISTRY: Japan Primary Registries Network; No.: JPRN-UMIN2404; URL: http://www.umin.ac.jp/ctr/.
RCT Entities:
BACKGROUND: We previously reported that patients with elevated preoperative B-type natriuretic peptide (BNP) levels have an increased risk for postoperative atrial fibrillation following lung cancer surgery. The present study evaluated whether the specific phosphodiesterase III inhibitor olprinone can reduce the incidence of postoperative atrial fibrillation in patients with elevated BNP levels undergoing pulmonary resection for lung cancer. METHODS: A prospective randomized study was conducted with 40 patients who had elevated preoperative BNP levels (≥ 30 pg/mL) and underwent scheduled lung cancer surgery. All patients were in sinus rhythm at surgery. Low-dose olprinone or placebo was continuously infused for 24 h and started just before anesthesia induction. The primary end point was the incidence of postoperative atrial fibrillation. The secondary end points were perioperative hemodynamics and levels of BNP, WBC counts, and C-reactive protein. RESULTS: The incidence of postoperative atrial fibrillation was significantly lower in the olprinone group than in the placebo group (10% vs 60%, P < .001). Patients in the olprinone group showed significantly lower BNP, WBC counts, and C-reactive protein levels after surgery. CONCLUSIONS: Continuous infusion of olprinone during lung cancer surgery was safe and reduced the incidence of postoperative atrial fibrillation following pulmonary resection in patients with elevated preoperative BNP levels. TRIAL REGISTRY: Japan Primary Registries Network; No.: JPRN-UMIN2404; URL: http://www.umin.ac.jp/ctr/.
Authors: David Amar; Hao Zhang; Kay See Tan; Daniel Piening; Valerie W Rusch; David R Jones Journal: J Thorac Cardiovasc Surg Date: 2019-01-31 Impact factor: 5.209