Metoprolol vs. carvedilol or carvedilol plus N-acetyl cysteine on post-operative atrial fibrillation: a randomized, double-blind, placebo-controlled study
Metoprolol vs. carvedilol or carvedilol plus N-acetyl cysteine on post-operative atrial fibrillation: a randomized, double-blind, placebo-controlled study
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DOI：
10.1093/eurheartj/ehs423
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发表时间：
2013-02-01
影响因子：
39.3
通讯作者：
Okutan, Huseyin
中科院分区：
文献类型：
--
作者：
Ozaydin, Mehmet;Icli, Atilla;Okutan, Huseyin
目的卡维地洛和n -乙酰半胱氨酸（NAC）具有抗氧化和抗炎作用。目的评价美托洛尔、卡维地洛及卡维地洛联合NAC预防术后房颤（POAF）的疗效。方法和结果接受心脏手术的患者（n = 311）随机分为美托洛尔、卡维地洛或卡维地洛加NAC组。基线特征相似。卡维地洛联合NAC组POAF发生率低于美托洛尔组（P < 0.0001）或卡维地洛组（P = 0.03）。卡维地洛组与美托洛尔组相比，POAF发生率较低具有临界意义（P = 0.06）。卡维地洛加NAC组住院时间低于美托洛尔组（P = 0.004）。POAF的多因素独立预测因子包括左房内径、高血压、旁路持续时间、随机化前和术前心率、卡维地洛加NAC组与美托洛尔组、卡维地洛加NAC组与卡维地洛组。结论卡维地洛联合NAC与美托洛尔相比可降低POAF发生率和住院时间，与卡维地洛相比可降低POAF发生率。
Aims Carvedilol and N-acetyl cysteine (NAC) have antioxidant and anti-inflammatory properties. Aim was to evaluate the efficacy of metoprolol, carvedilol, and carvedilol plus NAC on the prevention of post-operative atrial fibrillation (POAF).Methods and results Patients undergoing cardiac surgery (n = 311) were randomized to metoprolol, carvedilol, or carvedilol plus NAC. Baseline characteristics were similar. The incidence of POAF was lower in the carvedilol plus NAC group compared with the metoprolol group (P < 0.0001) or the carvedilol group (P = 0.03). There was a borderline significance for lower POAF rates in the carvedilol group compared with the metoprolol group (P = 0.06). Duration of hospitalization was lower in the carvedilol plus NAC group compared to the metoprolol group (P = 0.004). Multivariate independent predictors of POAF included left-atrial diameter, hypertension, bypass duration, pre-randomization and pre-operative heart rates, carvedilol plus NAC group vs. metoprolol group, and carvedilol plus NAC group vs. carvedilol group.Conclusion Carvedilol plus NAC decreased POAF incidence and duration of hospitalization compared with metoprolol and decreased POAF incidence compared with carvedilol.