Takahiko Tamura1, Tomoaki Yatabe2, Masataka Yokoyama1. 1. Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan. 2. Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan. Electronic address: yatabe@kochi-u.ac.jp.
Abstract
STUDY OBJECTIVE: Atrial fibrillation (AF) is associated with mortality after cardiac surgery. Several studies have reported that landiolol might help to prevent postoperative AF. The objective of this study was to investigate whether low-dose landiolol is useful in terms of balance of benefit and risk. DESIGN: We conducted a meta-analysis after systematically searching the PubMed, the Cochrane library and the ICHUSHI to identify randomized, controlled trials investigating the preventive effect of landiolol on incidence of AF after cardiac surgery. PATIENTS: Six randomized trial with 571 patients were included. MEASUREMENTS: The primary outcome was incidence of AF after surgery, while secondary outcomes were mortality and complications. MAIN RESULTS: Incidence of AF within 1week after surgery was significantly lower in the landiolol group than in the control group (odds ratio, 0.27; 95% confidence interval, 0.18-0.42; p<0.001). Three of the 6 studies reported data regarding in-hospital mortality and complications, showing no significant differences between groups (0.7 vs 3.0%; OR, 0.45; 95% CI, 0.07-2.74; p=0.39; and 4.5 vs 9.7%; OR, 0.45; 95% CI, 0.16-1.23; p=0.12, respectively). CONCLUSIONS: Our systematic review revealed that low-dose landiolol might help to prevent AF after cardiac surgery and further large trials are needed to evaluate safety because mortality and morbidity rate were very low in included studies.
STUDY OBJECTIVE:Atrial fibrillation (AF) is associated with mortality after cardiac surgery. Several studies have reported that landiolol might help to prevent postoperative AF. The objective of this study was to investigate whether low-dose landiolol is useful in terms of balance of benefit and risk. DESIGN: We conducted a meta-analysis after systematically searching the PubMed, the Cochrane library and the ICHUSHI to identify randomized, controlled trials investigating the preventive effect of landiolol on incidence of AF after cardiac surgery. PATIENTS: Six randomized trial with 571 patients were included. MEASUREMENTS: The primary outcome was incidence of AF after surgery, while secondary outcomes were mortality and complications. MAIN RESULTS: Incidence of AF within 1week after surgery was significantly lower in the landiolol group than in the control group (odds ratio, 0.27; 95% confidence interval, 0.18-0.42; p<0.001). Three of the 6 studies reported data regarding in-hospital mortality and complications, showing no significant differences between groups (0.7 vs 3.0%; OR, 0.45; 95% CI, 0.07-2.74; p=0.39; and 4.5 vs 9.7%; OR, 0.45; 95% CI, 0.16-1.23; p=0.12, respectively). CONCLUSIONS: Our systematic review revealed that low-dose landiolol might help to prevent AF after cardiac surgery and further large trials are needed to evaluate safety because mortality and morbidity rate were very low in included studies.
Authors: X Chapalain; J F Oilleau; L Henaff; P Lorillon PharmD; D Le Saout; P Kha; K Pluchon; E Bezon; O Huet Journal: Eur Heart J Suppl Date: 2022-06-13 Impact factor: 1.624
Authors: Hermann Blessberger; Sharon R Lewis; Michael W Pritchard; Lizzy J Fawcett; Hans Domanovits; Oliver Schlager; Brigitte Wildner; Juergen Kammler; Clemens Steinwender Journal: Cochrane Database Syst Rev Date: 2019-09-23
Authors: Martin Unger; Andrea Morelli; Mervyn Singer; Peter Radermacher; Sebastian Rehberg; Helmut Trimmel; Michael Joannidis; Gottfried Heinz; Vladimír Cerny; Pavel Dostál; Christian Siebers; Fabio Guarracino; Francesca Pratesi; Gianni Biancofiore; Massimo Girardis; Pavla Kadlecova; Olivier Bouvet; Michael Zörer; Barbara Grohmann-Izay; Kurt Krejcy; Christoph Klade; Günther Krumpl Journal: Trials Date: 2018-11-19 Impact factor: 2.279