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心脏手术患者术前抗高血压药物与术后心房颤动的关系:一项荟萃分析

Preoperative Antihypertensive Medication in Relation to Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery: A Meta-Analysis.

作者信息

Zhou Ai-Guo, Wang Xian-Xue, Pan Dao-Bo, Chen An-Ji, Zhang Xiong-Fei, Deng Hui-Wei

机构信息

Department of Anesthesiology of the First People's Hospital of Changde City, Changde, Hunan, China.

出版信息

Biomed Res Int. 2017;2017:1203538. doi: 10.1155/2017/1203538. Epub 2017 Feb 13.

Abstract

. We undertake a systematic review and meta-analysis to evaluate the effect of preoperative hypertension and preoperative antihypertensive medication to postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery. . We searched PubMed, Embase, and Cochrane Library (from inception to March 2016) for eligible studies. The outcomes were the effects of preoperative hypertension, preoperative calcium antagonists regimen, preoperative ACE inhibitors regimen, and preoperative beta blocking agents regimen with POAF. We calculated pooled risk ratios (OR) and 95% CIs using random- or fixed-effects models. . Twenty-five trials involving 130087 patients were listed. Meta-analysis showed that the number of preoperative hypertension patients in POAF group was significantly higher ( < 0.05), while we found that there are no significant differences between two groups in Asia patients by subgroup analysis, which is in contrast to other outcomes. Compared with the Non-POAF group, the number of patients who used calcium antagonists and ACE inhibitors preoperatively in POAF group was significantly higher ( < 0.05). And we found that there were no significant differences between two groups of preoperative beta blocking agents used ( = 0.08). . Preoperative hypertension and preoperative antihypertensive medication in patients undergoing cardiac operations seem to be associated with higher risk of POAF.

摘要

我们进行了一项系统评价和荟萃分析,以评估心脏手术患者术前高血压和术前抗高血压药物对术后心房颤动(POAF)的影响。我们检索了PubMed、Embase和Cochrane图书馆(从创刊至2016年3月)以查找符合条件的研究。结局指标为术前高血压、术前钙拮抗剂方案、术前血管紧张素转换酶抑制剂方案和术前β受体阻滞剂方案对POAF的影响。我们使用随机或固定效应模型计算合并风险比(OR)和95%置信区间。列出了涉及130087例患者的25项试验。荟萃分析显示,POAF组术前高血压患者数量显著更高(<0.05),而亚组分析发现亚洲患者两组之间无显著差异,这与其他结局相反。与非POAF组相比,POAF组术前使用钙拮抗剂和血管紧张素转换酶抑制剂的患者数量显著更高(<0.05)。并且我们发现两组术前使用β受体阻滞剂无显著差异(=0.08)。心脏手术患者术前高血压和术前抗高血压药物似乎与POAF风险较高相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41c8/5327763/99703384cd3e/BMRI2017-1203538.001.jpg

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