Abacilar Ahmet Feyzi, Dogan Omer Faruk
Heart Surg Forum. 2013 Oct;16(5):E287-94. doi: 10.1532/hsf98.2013190.
Atrial fibrillation (AF) often occurs after coronary artery bypass grafting (CABG) and can result in increased morbidity and mortality due to complications. In the present study, our goal was to investigate whether the use of levosimendan can reduce the frequency of AF after coronary artery bypass grafting in patients with poor left ventricle function.
To investigate the effectiveness of levosimendan in the prophylaxis of AF, we conducted a prospective, randomized, placebo-controlled clinical study on 200 consecutive patients in whom we performed elective CABG operations. Baseline characteristics were similar in both groups. A control group of 100 patients were treated with placebo (500 mL saline solution), whereas the levosimendan group (n = 100 patients) was treated with levosimendan. High-sensitivity C-reactive protein, cardiac troponin, and creatine kinase–MB levels were measured before surgery and 5 days postoperatively.
AF occurred in 12% of the levosimendan group and 36% of the control group. The occurrence of AF was significantly lower in the levosimendan group (P < 0.05). The duration of AF in the levosimendan group was significantly shorter than that in the control group (4.83 ± 1.12 and 6.50 ± 1.55 hours, respectively; P = 0.028). Our research showed that C-reactive protein was higher postoperatively in the control group than in the levosimendan group (P < 0.05).
The incidence of postoperative AF in the levosimendan group was reduced significantly in patients with poor left ventricle function after CABG operations.
冠状动脉旁路移植术(CABG)后常发生心房颤动(AF),并可因并发症导致发病率和死亡率增加。在本研究中,我们的目标是调查左西孟旦的使用是否能降低左心室功能不佳患者冠状动脉旁路移植术后房颤的发生率。
为研究左西孟旦预防房颤的有效性,我们对200例连续接受择期CABG手术的患者进行了一项前瞻性、随机、安慰剂对照的临床研究。两组的基线特征相似。100例患者的对照组接受安慰剂治疗(500 mL生理盐水),而左西孟旦组(n = 100例患者)接受左西孟旦治疗。在手术前和术后5天测量高敏C反应蛋白、心肌肌钙蛋白和肌酸激酶-MB水平。
左西孟旦组房颤发生率为12%,对照组为36%。左西孟旦组房颤发生率显著较低(P < 0.05)。左西孟旦组房颤持续时间显著短于对照组(分别为4.83 ± 1.12小时和6.50 ± 1.55小时;P = 0.028)。我们的研究表明,对照组术后C反应蛋白高于左西孟旦组(P < 0.05)。
CABG术后左心室功能不佳患者中,左西孟旦组术后房颤发生率显著降低。