초록접수 현황
| 19F-247 | 구연 발표 |
Perioperative Beta-Blocker For Atrial Fibrillation after Cardiac Surgery: A Meta-Analysis
Sue Hyun Kim¹, Myoung-jin Jang², Ho Young Hwang¹
¹Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea, ²Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : This meta-analysis was conducted to evaluate the impact of perioperative use of BB on POAF after cardiac surgery other than isolated CABG.
Methods : Five online databases were searched. Studies were included if they (1) enrolled patients who underwent cardiac surgery other than isolated CABG and (2) demonstrated the impact of perioperative use of BB on POAF based on the randomized controlled trial or adjusted analysis. The primary outcome was the occurrence rates of POAF after cardiac surgery. A meta-regression and Subgroup analysis were performed according to the proportion of patients with cardiac surgery other than isolated CABG and the timing of BB use, respectively.
Results : Thirteen articles (5 randomized and 8 non-randomized studies: n=25,496) were selected. Proportion of enrolled patients undergoing cardiac surgery other than isolated CABG ranged from 7% to 100%. The BBs were used in preoperative, postoperative and both periods in 5, 5 and 3 studies, respectively. The pooled analyses showed that the risk of POAF was significantly lower in patients with perioperative BB than those without (odds ratio, 95% confidence interval=0.56, 0.35-0.91 and 0.70, 0.55-0.91 in randomized and non-randomized studies, respectively). The risk of POAF was lower in the BB group irrespective of the proportion of non-isolated CABG. Benefit regarding in-hospital mortality was inconclusive. Perioperative stroke and LOS were not significantly different between BB and non-BB groups.
Conclusion : Perioperative use of BB is effective in preventing POAF even in patients undergoing cardiac surgery other than isolated CABG, although it did not translate into improved clinical outcomes.
Methods : Five online databases were searched. Studies were included if they (1) enrolled patients who underwent cardiac surgery other than isolated CABG and (2) demonstrated the impact of perioperative use of BB on POAF based on the randomized controlled trial or adjusted analysis. The primary outcome was the occurrence rates of POAF after cardiac surgery. A meta-regression and Subgroup analysis were performed according to the proportion of patients with cardiac surgery other than isolated CABG and the timing of BB use, respectively.
Results : Thirteen articles (5 randomized and 8 non-randomized studies: n=25,496) were selected. Proportion of enrolled patients undergoing cardiac surgery other than isolated CABG ranged from 7% to 100%. The BBs were used in preoperative, postoperative and both periods in 5, 5 and 3 studies, respectively. The pooled analyses showed that the risk of POAF was significantly lower in patients with perioperative BB than those without (odds ratio, 95% confidence interval=0.56, 0.35-0.91 and 0.70, 0.55-0.91 in randomized and non-randomized studies, respectively). The risk of POAF was lower in the BB group irrespective of the proportion of non-isolated CABG. Benefit regarding in-hospital mortality was inconclusive. Perioperative stroke and LOS were not significantly different between BB and non-BB groups.
Conclusion : Perioperative use of BB is effective in preventing POAF even in patients undergoing cardiac surgery other than isolated CABG, although it did not translate into improved clinical outcomes.
책임저자: Ho Young Hwang
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Sue Hyun Kim, E-mail : annesue01@gmail.com