Rahul Chaudhary1, Jalaj Garg2, Mohit Turagam3, Rohit Chaudhary4, Rahul Gupta5, Talha Nazir6, Babak Bozorgnia6, Christine Albert6, Dhanunjaya Lakkireddy7. 1. Department of Medicine, Mayo Clinic, Rochester, MN. 2. Division of Cardiology, Cardiac Arrhythmia Service, Medical College of Wisconsin Milwaukee, WI. 3. Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai Hospital, New York, NY. 4. Peter Lee Associates, Sydney, Australia. 5. Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY. 6. Division of Cardiology, Lehigh Valley Health Network, Allentown, PA. 7. Kansas City Heart Rhythm Institute and Research Foundation, Kansas City, Kansas.
Abstract
BACKGROUND: Several randomized trials have evaluated the efficacy of prophylactic magnesium (Mg) supplementation in prevention of post-operative atrial fibrillation (POAF) in patients undergoing cardiac artery bypass grafting (CABG). We aimed to determine the role of prophylactic Mg in 3 different settings (intraoperative, postoperative, intraoperative plus postoperative) in prevention of POAF. METHODS: A systemic literature search was performed (until January 19, 2019) using PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials to identify trials evaluating Mg supplementation post CABG. Primary outcome of our study was reduction in POAF post CABG. RESULTS: We included a total of 2,430 participants (1,196 in the Mg group and 1,234 in the placebo group) enrolled in 20 randomized controlled trials. Pooled analysis demonstrated no reduction in POAF between the two groups (RR 0.90; 95% CI, 0.79-1.03; p=0.13; I2=42.9%). In subgroup analysis, significant reduction in POAF was observed with postoperative Mg supplementation (RR 0.76; 95% CI, 0.58-0.99; p=0.04; I2=17.6%) but not with intraoperative or intraoperative plus postoperative Mg supplementation (RR 0.77; 95% CI, 0.49-1.22; p = 0.27; I2=49% and RR 0.92; 95% CI, 0.68-1.24; p = 0.58; I2=51.8%, respectively). CONCLUSIONS: Magnesium supplementation, especially in the postoperative period, is an effective strategy in reducing POAF following CABG.
BACKGROUND: Several randomized trials have evaluated the efficacy of prophylactic magnesium (Mg) supplementation in prevention of post-operative atrial fibrillation (POAF) in patients undergoing cardiac artery bypass grafting (CABG). We aimed to determine the role of prophylactic Mg in 3 different settings (intraoperative, postoperative, intraoperative plus postoperative) in prevention of POAF. METHODS: A systemic literature search was performed (until January 19, 2019) using PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials to identify trials evaluating Mg supplementation post CABG. Primary outcome of our study was reduction in POAF post CABG. RESULTS: We included a total of 2,430 participants (1,196 in the Mg group and 1,234 in the placebo group) enrolled in 20 randomized controlled trials. Pooled analysis demonstrated no reduction in POAF between the two groups (RR 0.90; 95% CI, 0.79-1.03; p=0.13; I2=42.9%). In subgroup analysis, significant reduction in POAF was observed with postoperative Mg supplementation (RR 0.76; 95% CI, 0.58-0.99; p=0.04; I2=17.6%) but not with intraoperative or intraoperative plus postoperative Mg supplementation (RR 0.77; 95% CI, 0.49-1.22; p = 0.27; I2=49% and RR 0.92; 95% CI, 0.68-1.24; p = 0.58; I2=51.8%, respectively). CONCLUSIONS: Magnesium supplementation, especially in the postoperative period, is an effective strategy in reducing POAF following CABG.
Authors: Stefano Forlani; Ruggero De Paulis; Stefano de Notaris; Paolo Nardi; Fabrizio Tomai; Igino Proietti; Anna S Ghini; Luigi Chiariello Journal: Ann Thorac Surg Date: 2002-09 Impact factor: 4.330