水飞蓟素对冠状动脉旁路移植术后预防心房颤动的影响。
The Effect of Silymarin on the Prevention of Atrial Fibrillation After Coronary Artery Bypass Grafting.
机构信息
Cardiac Surgery Department, Institute for Cardiovascular Diseases Dedinje, Belgrade, Serbia.
Cardiac Surgery Department, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
出版信息
Braz J Cardiovasc Surg. 2024 Nov 28;e20230422(e20230422):e20230422. doi: 10.21470/1678-9741-2023-0422.
INTRODUCTION
Postoperative atrial fibrillation is a frequent complication after coronary artery bypass grafting and is associated with increased mortality. The effects of various drugs on the occurrence of postoperative atrial fibrillation have been studied, but no one has looked into the effect of silymarin on the occurrence of postoperative atrial fibrillation.
METHODS
This prospective experimental study included 160 patients undergoing coronary artery bypass grafting. The experimental group received 400 mg of silymarin orally three days before the surgery, while the control group did not. The occurrence of postoperative atrial fibrillation was monitored. Patients' clinical data and postoperative characteristics were investigated to elucidate their impact on postoperative atrial fibrillation.
RESULTS
Postoperative atrial fibrillation occurred in significantly fewer patients in the experimental group (14 vs. 30, P=0.008). There were also lower mean values of postoperatively measured C-reactive protein (P<0.0005) and aspartate aminotransferase (P=0.001) in the experimental group. Within the multivariate regression model, a non-silymarin group (odds ratio 0.296 [0.109-0.807], P=0.005), postoperative red blood cell transfusion (odds ratio 5.218 [1.930-14.107], P=0.001), left atrial diameter (odds ratio 7.800 [2.122-28.672], P=0.002), postoperative C-reactive protein (odds ratio 1.020 [1.008-1.032], P=0.001), and CHA₂DS₂-VASc score (standing for congestive heart failure, hypertension, age ≥ 75 years [doubled], diabetes, stroke [doubled], vascular disease, age 65 to 74 years, and sex category [female]) (odds ratio 1.873 [1.279-2.743], P=0.001) proved to be independently associated with the development of postoperative atrial fibrillation.
CONCLUSION
This study showed that preoperative administration of silymarin significantly reduces the development of atrial fibrillation after coronary artery bypass grafting.
简介
术后心房颤动是冠状动脉旁路移植术后常见的并发症，与死亡率增加有关。已有研究探讨了各种药物对术后心房颤动发生的影响，但尚未有人研究水飞蓟素对术后心房颤动发生的影响。
方法
本前瞻性实验研究纳入了 160 例行冠状动脉旁路移植术的患者。实验组术前 3 天口服 400mg 水飞蓟素，对照组则未服用。监测术后心房颤动的发生情况。调查患者的临床数据和术后特征，以阐明其对术后心房颤动的影响。
结果
实验组患者术后心房颤动的发生率明显较低（14 例 vs. 30 例，P=0.008）。实验组术后测量的 C 反应蛋白（P<0.0005）和天冬氨酸转氨酶（P=0.001）的平均值也较低。在多变量回归模型中，未服用水飞蓟素组（比值比 0.296 [0.109-0.807]，P=0.005）、术后红细胞输注（比值比 5.218 [1.930-14.107]，P=0.001）、左心房直径（比值比 7.800 [2.122-28.672]，P=0.002）、术后 C 反应蛋白（比值比 1.020 [1.008-1.032]，P=0.001）和 CHA₂DS₂-VASc 评分（充血性心力衰竭、高血压、年龄≥75 岁[加倍]、糖尿病、中风[加倍]、血管疾病、年龄 65-74 岁和性别类别[女性]）（比值比 1.873 [1.279-2.743]，P=0.001）均与术后心房颤动的发生独立相关。
结论
本研究表明，术前给予水飞蓟素可显著降低冠状动脉旁路移植术后心房颤动的发生。
Zotero 插件