Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran.
Naunyn Schmiedebergs Arch Pharmacol. 2024 Dec;397(12):9935-9946. doi: 10.1007/s00210-024-03225-1. Epub 2024 Jul 2.
This study is aimed at evaluating the effect of empagliflozin in preventing atrial fibrillation after coronary artery bypass grafting (CABG). Eighty-two patients who fulfilled the inclusion criteria were allocated to the empagliflozin group (n = 43) or placebo group (n = 39). In two groups, patients received empagliflozin or placebo tablets 3 days before surgery and on the first three postoperative days (for 6 days) in addition to the standard regimen during hospitalization. During the first 3 days after surgery, types of arrhythmias after cardiac surgery, including supraventricular arrhythmias, especially postoperative atrial fibrillation (POAF), ventricular arrhythmias, and heart blocks, were assessed by electrocardiogram monitoring. C-reactive protein (CRP) levels were evaluated pre-operatively and postoperative on the third day. The incidence of POAF in the treatment group was lower compared to the control group; however, this reduction was statistically non-significant (p = 0.09). The frequency of ventricular tachycardia was reduced significantly in the treatment group versus patients in the control (p = 0.02). Also, a significant reduction in the frequency of premature ventricular contractions (PVCs) was seen in the treatment group in comparison with the control group (p = 0.001). After the intervention, CRP levels were significantly less in the empagliflozin group compared to the control group in the third postoperative day (p = 0.04). The prophylactic use of empagliflozin effectively reduced the incidence of ventricular arrhythmia in patients undergoing CABG surgery.
本研究旨在评估恩格列净在预防冠状动脉旁路移植术后心房颤动(CABG)中的作用。符合纳入标准的 82 名患者被分配到恩格列净组(n=43)或安慰剂组(n=39)。两组患者均在手术前 3 天和术后第 1 至第 3 天(共 6 天)开始服用恩格列净或安慰剂片,同时在住院期间接受标准治疗方案。术后前 3 天,通过心电图监测评估心脏手术后的心律失常类型,包括房性心律失常,特别是术后心房颤动(POAF)、室性心律失常和心脏阻滞。术前和术后第 3 天评估 C 反应蛋白(CRP)水平。与对照组相比,治疗组 POAF 的发生率较低,但差异无统计学意义(p=0.09)。与对照组相比,治疗组室性心动过速的频率明显降低(p=0.02)。此外,与对照组相比,治疗组室性早搏(PVC)的频率也显著降低(p=0.001)。干预后,与对照组相比,恩格列净组第 3 天 CRP 水平显著降低(p=0.04)。预防性使用恩格列净可有效降低 CABG 手术患者室性心律失常的发生率。