Wilbring Manuel, Ploetze Katrin, Bormann Susann, Waldow Thomas, Matschke Klaus
Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany.
Thorac Cardiovasc Surg. 2014 Oct;62(7):569-74. doi: 10.1055/s-0034-1371699. Epub 2014 Apr 22.
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
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.
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).
Preoperative administration of 2 g omega-3 PUFA reduces incidence of postoperative AF in patients with recent (≤ 3 months) myocardial infarction undergoing isolated CABG.
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。
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。
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)。
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。