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经皮比索洛尔预防术后房颤：系统评价与荟萃分析

Transdermal bisoprolol for prevention of postoperative atrial fibrillation: A systematic review and meta-analysis.

作者信息

Kim Andrew G, Banga Sandeep, Ang Qi Xuan, Atti Lalitsiri, Ghnaima Harith, AlAttal Saif, Banga Preeti, Wilcox Matthew D

机构信息

Internal Medicine Michigan State University East Lansing Michigan USA.

Cardiology, Michigan State University East Lansing Michigan USA.

出版信息

J Arrhythm. 2024 May 2;40(3):434-439. doi: 10.1002/joa3.13049. eCollection 2024 Jun.

DOI:10.1002/joa3.13049
PMID:38939760
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11199842/
Abstract

BACKGROUND

The transdermal patch of bisoprolol available in Japan has been reported to demonstrate superior efficacy in preventing postoperative atrial fibrillation, possibly surpassing its oral counterpart. However, there has been no systematic review and meta-analysis assessing the efficacy of transdermal bisoprolol.

METHODS

A comprehensive systematic literature search was conducted on PubMed, Embase, and Cochrane to identify all relevant studies assessing the efficacy of transdermal bisoprolol in preventing postoperative atrial fibrillation. The search covered studies from inception up to December 4, 2023. For data analysis, Review Manager (RevMan) 5.4 software was employed, using a random-effects model to calculate risk ratios (RR) and 95% confidence intervals (CI).

RESULTS

Three studies, comprising a total of 551 patients (transdermal bisoprolol 228 and control 323), were included. There was a decreased risk of postoperative atrial fibrillation or atrial tachyarrhythmias in patients treated with transdermal bisoprolol (RR 0.43, 95% CI 0.27-0.67,  = .0002,  = 0%).

CONCLUSION

Transdermal administration of bisoprolol has consistently shown efficacy, and this pooled analysis supports its effectiveness. The heterogeneity of the included studies limits certain interpretations. Future randomized clinical trials may elucidate the superiority of transdermal administration over oral administration.

摘要

背景

据报道，日本上市的比索洛尔透皮贴剂在预防术后房颤方面显示出卓越疗效，可能优于口服制剂。然而，尚未有系统评价和荟萃分析评估比索洛尔透皮贴剂的疗效。

方法

在PubMed、Embase和Cochrane上进行了全面的系统文献检索，以识别所有评估比索洛尔透皮贴剂预防术后房颤疗效的相关研究。检索涵盖从研究起始至2023年12月4日的研究。数据分析采用Review Manager（RevMan）5.4软件，使用随机效应模型计算风险比（RR）和95%置信区间（CI）。

结果

纳入三项研究，共551例患者（比索洛尔透皮贴剂组228例，对照组323例）。使用比索洛尔透皮贴剂治疗的患者术后房颤或房性快速心律失常风险降低（RR 0.43，95%CI 0.27 - 0.67，P = 0.0002，I² = 0%）。

结论

比索洛尔透皮给药一直显示出疗效，本次汇总分析支持其有效性。纳入研究的异质性限制了某些解释。未来的随机临床试验可能会阐明透皮给药相对于口服给药的优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3820/11199842/8d2805457a61/JOA3-40-434-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3820/11199842/8279fecebd33/JOA3-40-434-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3820/11199842/8d2805457a61/JOA3-40-434-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3820/11199842/8279fecebd33/JOA3-40-434-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3820/11199842/8d2805457a61/JOA3-40-434-g003.jpg

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本文引用的文献

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J Cardiothorac Surg. 2023 Apr 6;18(1):103. doi: 10.1186/s13019-023-02227-z.
2
Impact of bisoprolol transdermal patch on early recurrence during the blanking period after atrial fibrillation ablation.比索洛尔透皮贴剂对心房颤动消融术后空白期早期复发的影响。
J Arrhythm. 2021 May 4;37(3):607-615. doi: 10.1002/joa3.12538. eCollection 2021 Jun.
3
Preventative effects of bisoprolol transdermal patches on postoperative atrial fibrillation in high-risk patients undergoing non-cardiac surgery: A subanalysis of the MAMACARI study.
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4
Long-Term Evaluation of the Vagal Denervation by Cardioneuroablation Using Holter and Heart Rate Variability.使用 Holter 监测和心率变异性评估心脏去神经支配的长期效果。
Circ Arrhythm Electrophysiol. 2020 Dec;13(12):e008703. doi: 10.1161/CIRCEP.120.008703. Epub 2020 Nov 16.
5
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SAGE Open Med. 2020 Feb 20;8:2050312120907817. doi: 10.1177/2050312120907817. eCollection 2020.
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