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秋水仙碱降低心肌血运重建术后房颤发生率

Colchicine to Reduce Atrial Fibrillation in the Postoperative Period of Myocardial Revascularization.

作者信息

Zarpelon Camila Stuchi, Netto Miguel Chomiski, Jorge José Carlos Moura, Fabris Cátia Carolina, Desengrini Dieli, Jardim Mariana da Silva, Silva Diego Guedes da

机构信息

Santa Casa de Misericórdia de Curitiba, Curitiba, PR, Brazil.

出版信息

Arq Bras Cardiol. 2016 Jul;107(1):4-9. doi: 10.5935/abc.20160082. Epub 2016 May 24.

Abstract

BACKGROUND

The high prevalence of atrial fibrillation (AF) in the postoperative period of myocardial revascularization surgery increases morbidity and mortality.

OBJECTIVE

To assess the efficacy of colchicine to prevent AF in the postoperative period of myocardial revascularization surgery, the impact of AF on hospital length of stay and death, and to identify its risk factors.

METHODS

Between May 2012 and November 2013, 140 patients submitted to myocardial revascularization surgery were randomized, 69 to the control group and 71 to the colchicine group. Colchicine was used at the dose of 1 mg orally, twice daily, preoperatively, and of 0.5 mg, twice daily, until hospital discharge. A single dose of 1 mg was administered to those admitted 12 hours or less before surgery.

RESULTS

The primary endpoint was AF rate in the postoperative period of myocardial revascularization surgery. Colchicine group patients showed no reduction in AF incidence as compared to control group patients (7.04% versus 13.04%, respectively; p = 0.271). There was no statistically significant difference between the groups regarding death from any cause rate (5.6% versus 10.1%; p = 0,363) and hospital length of stay (14.5 ± 11.5 versus 13.3 ± 9.4 days; p = 0.490). However, colchicine group patients had a higher infection rate (26.8% versus 8.7%; p = 0.007).

CONCLUSION

The use of colchicine to prevent AF after myocardial revascularization surgery was not effective in the present study. Brazilian Registry of Clinical Trials number RBR-556dhr.

摘要

背景

心肌血运重建术后房颤(AF)的高发生率增加了发病率和死亡率。

目的

评估秋水仙碱在心肌血运重建术后预防房颤的疗效、房颤对住院时间和死亡的影响,并确定其危险因素。

方法

2012年5月至2013年11月,140例行心肌血运重建术的患者被随机分组,69例入对照组,71例入秋水仙碱组。术前秋水仙碱剂量为口服1mg,每日2次,术后至出院剂量为0.5mg,每日2次。手术前12小时或更短时间入院的患者给予单次剂量1mg。

结果

主要终点是心肌血运重建术后房颤发生率。与对照组患者相比,秋水仙碱组患者房颤发生率未降低(分别为7.04%和13.04%;p = 0.271)。两组在任何原因导致的死亡率(5.6%对10.1%;p = 0.363)和住院时间(14.5±11.5天对13.3±9.4天;p = 0.490)方面无统计学显著差异。然而,秋水仙碱组患者感染率较高(26.8%对8.7%;p = 0.007)。

结论

在本研究中,使用秋水仙碱预防心肌血运重建术后房颤无效。巴西临床试验注册号RBR-556dhr。

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Atrial fibrillation after cardiac surgery.心脏手术后的心房颤动
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Postoperative atrial fibrillation after cardiac surgery.心脏手术后的心房颤动。
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Recent developments in pharmacologic prophylaxis of atrial fibrillation in patients undergoing surgical revascularization.
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