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ω-3多不饱和脂肪酸可降低既往有心肌梗死病史且接受单纯冠状动脉旁路移植术患者术后房颤的发生率。

Omega-3 polyunsaturated Fatty acids reduce the incidence of postoperative atrial fibrillation in patients with history of prior myocardial infarction undergoing isolated coronary artery bypass grafting.

作者信息

Wilbring Manuel, Ploetze Katrin, Bormann Susann, Waldow Thomas, Matschke Klaus

机构信息

Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany.

出版信息

Thorac Cardiovasc Surg. 2014 Oct;62(7):569-74. doi: 10.1055/s-0034-1371699. Epub 2014 Apr 22.

Abstract

INTRODUCTION

The impact of omega-3 polyunsaturated fatty acids (PUFAs) for prevention of atrial fibrillation (AF) is still part of a lively debate. The present study evaluates the impact of orally administered omega-3 ethyl ester concentrate (omega-3 PUFA) on postoperative onset of AF in patients with recent myocardial infarction (≤ 3 months) undergoing isolated coronary artery bypass grafting (CABG). Patients and

METHODS

The study included a total of 198 patients with recent (≤ 3 months) myocardial infarction. The treatment group consisted of 99 prospectively and randomly assigned patients. A matched control group was generated out of the entirety of patients undergoing isolated CABG during the same time period, being not treated with omega-3 PUFA. Primary endpoint was onset of postoperative AF. Patients of the treatment group received a daily dose of 2 g omega-3 PUFA, initiated 5 days before surgery. Effective serum levels were confirmed by laboratory testing.

RESULTS

Patients of the treatment group had less frequently postoperative AF (treatment: 31.3% vs. control: 48.0%; p = 0.017). The reduction in relative risk was 34.8% in the treatment group, which conforms a number needed to treat (NNT) of 6.0 patients. A more pronounced effect with a NNT of 4.1 was observed in patients ≤ 70 years (p = 0.007). Besides, patients of the treatment group had a shorter intensive care unit stay (p = 0.001) and suffered less frequently from impaired wound healing by trend (p = 0.063). One patient out of treatment group and two out of control group died during hospital stay (p = 1.000).

CONCLUSION

Preoperative administration of 2 g omega-3 PUFA reduces incidence of postoperative AF in patients with recent (≤ 3 months) myocardial infarction undergoing isolated CABG.

摘要

引言

ω-3多不饱和脂肪酸(PUFA)对预防心房颤动(AF)的影响仍是一个激烈争论的话题。本研究评估口服ω-3乙酯浓缩物(ω-3PUFA)对近期心肌梗死(≤3个月)且接受单纯冠状动脉旁路移植术(CABG)患者术后房颤发作的影响。

患者与方法

本研究共纳入198例近期(≤3个月)心肌梗死患者。治疗组由99例前瞻性随机分配的患者组成。从同期接受单纯CABG且未接受ω-3PUFA治疗的所有患者中生成匹配对照组。主要终点是术后房颤发作。治疗组患者在术前5天开始每日服用2gω-3PUFA。通过实验室检测确认有效血清水平。

结果

治疗组患者术后房颤发生率较低(治疗组:31.3% vs. 对照组:48.0%;p = 0.017)。治疗组相对风险降低34.8%,即需治疗人数(NNT)为6.0例患者。在≤70岁的患者中观察到更显著的效果,NNT为4.1(p = 0.007)。此外,治疗组患者重症监护病房住院时间较短(p = 0.001),且伤口愈合受损的发生率有降低趋势(p = 0.063)。治疗组1例患者和对照组2例患者在住院期间死亡(p = 1.000)。

结论

术前给予2gω-3PUFA可降低近期(≤3个月)心肌梗死且接受单纯CABG患者术后房颤的发生率。

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