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评估恩格列净对冠状动脉旁路移植术后预防心房颤动的效果:一项双盲、随机、安慰剂对照试验。

Evaluation of the effect of empagliflozin on prevention of atrial fibrillation after coronary artery bypass grafting: a double-blind, randomized, placebo-controlled trial.

机构信息

Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Naunyn Schmiedebergs Arch Pharmacol. 2024 Dec;397(12):9935-9946. doi: 10.1007/s00210-024-03225-1. Epub 2024 Jul 2.

Abstract

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.

摘要

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。

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