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鱼油补充剂用于冠状动脉旁路移植手术后预防心房颤动的一级预防:一项随机临床试验。

Fish oil supplementation for primary prevention of atrial fibrillation after coronary artery bypass graft surgery: A randomized clinical trial.

机构信息

Department of Cardiology, School of Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Operating Room Technology, Faculty of Paramedical Sciences, Urmia University of Medical Sciences, Urmia, Iran; Rajaie Cardiovascular Medical & Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Surg. 2017 Jun;42:41-48. doi: 10.1016/j.ijsu.2017.04.025. Epub 2017 Apr 15.

Abstract

BACKGROUND

Atrial fibrillation (AF) after cardiac surgery is a common complication that may influence patients' early and long term outcomes and hospital costs. The purpose of this study was to assess the effect of fish oil on occurrence of AF following coronary artery bypass graft surgery (CABG).

METHODS

This study was a single-center, randomized, double blinded, placebo-controlled clinical trial. Four-hundred and one patients undergoing coronary artery bypass graft surgery were randomly assigned to receive 2 g/d fish oil or placebo (olive oil) for at least 5 days before surgery. The primary end point was defined as time to AF improvement After AF incidence following isolated CABG or a need for pharmacologic therapy or cardioversion.

RESULTS

The time to AF improvement in intervention group was shorter than control group (HR: 2.05; 95% CI = 0.70-6.22, P = 0.20). The incidence of AF in the intervention and control groups was 8.40% vs. 14.07% respectively (p = 0.07). Mean total duration of AF was 20.96 ± 4.71 h in intervention groups and 46.87 ± 7.44 h in control groups (p = 0.04). Mean duration of stay in the ICU and total hospital stay showed a significant reduction in the intervention group (p = 0.003 and p = 0.04, respectively).

CONCLUSION

The consumption of PUFA leads to a shorter time to AF improvement, which was not statistically significant. The incidence of AF in patients undergoing CABG surgery was decreased by approximately 5.7%; which was statistically on the borderline. Fish oil reduced median length of stay in the ICU and hospital. Further well-designed studies are needed to overcome the limitations of the existing trials and provide conclusive conclusions.

摘要

背景

心脏手术后心房颤动(AF)是一种常见的并发症,可能会影响患者的早期和长期预后以及住院费用。本研究旨在评估鱼油对冠状动脉旁路移植术(CABG)后 AF 发生的影响。

方法

这是一项单中心、随机、双盲、安慰剂对照的临床试验。401 例行冠状动脉旁路移植术的患者被随机分为两组,分别接受 2g/d 鱼油或安慰剂(橄榄油)治疗,至少在术前 5 天开始。主要终点定义为 AF 改善的时间,AF 发生在单纯 CABG 后或需要药物治疗或电复律后。

结果

干预组 AF 改善时间短于对照组(HR:2.05;95%CI=0.70-6.22,P=0.20)。干预组和对照组的 AF 发生率分别为 8.40%和 14.07%(p=0.07)。干预组 AF 总持续时间为 20.96±4.71h,对照组为 46.87±7.44h(p=0.04)。干预组 ICU 停留时间和总住院时间均明显缩短(p=0.003 和 p=0.04)。

结论

PUFA 的消耗导致 AF 改善时间缩短,但无统计学意义。CABG 手术后 AF 的发生率降低了约 5.7%;这在统计学上是边缘的。鱼油减少了 ICU 和医院的中位住院时间。需要进一步进行设计良好的研究来克服现有试验的局限性并得出结论。

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