低剂量兰地洛尔对心脏手术后房颤的预防：系统性回顾和meta分析
本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见
Prevention of atrial fibrillation after cardiac surgery using low-dose landiolol: A systematic review and meta-analysis
背景与目的
心房颤动（AF）与心脏手术后的死亡率相关。 一些研究报道，兰地洛尔可能有助于预防术后房颤。 我们研究的目的是调查低剂量兰地洛尔的使用在术后利益和风险。
方 法
我们在系统地搜索PubMed，Cochrane图书馆和ICHUSHI后进行了meta分析，以确立调查兰地洛尔对心脏手术后房颤发生率的预防作用的随机试验。试验包括571例患者，测试6项随机数据：主要测量的是手术后房颤的发生率，其次是死亡率和并发症。
结 果
兰地洛尔组的术后房颤发生率明显低于正常对照组。6项研究中有3项报道了有关住院死亡率和并发症的数据，两组间差异无统计学意义。
结 论
我们的系统性评估显示，低剂量兰地洛尔可能有助于预防心脏手术后的房颤，但是因为现有研究中的死亡率和发病率非常低，还需要进一步的试验来评估安全性。
原始文献摘要
Takahiko Tamura, MD, PhD, Tomoaki Yatabe, Prevention of atrial fibrillation after cardiac surgery using low-dose landiolol: A systematic review and meta-analysis，Journal of Clinical Anesthesia 42 (2017) 1–6
PURPOSE:
Atrial fibrillation (AF) is associated with mortality after cardiac surgery. Several studies have reported that landiolol might help to prevent postoperative AF. The objective of this study was to investigate whether low-dose landiolol is useful in terms of balance of benefit and risk.
Design: We conducted a meta-analysis after systematically searching the PubMed, the Cochrane library and the ICHUSHI to identify randomized, controlled trials investigating the preventive effect of landiolol on incidence of AF after cardiac surgery.
METHODS:
Six randomized trial with 571 patients were included.Measurements: The primary outcome was incidence of AF after surgery, while secondary outcomes were mortality and complications.
RESULTS:
Incidence of AF within 1 week after surgery was significantly lower in the landiolol group than in the control group (odds ratio, 0.27; 95% confidence interval, 0.18–0.42; p b 0.001). Three of the 6 studies reported data regarding in-hospital mortality and complications, showing no significant differences between groups(0.7vs3.0%; OR, 0.45;95% CI, 0.07–2.74;p = 0.39; and 4.5 vs 9.7%;OR, 0.45; 95% CI,0.16–1.23; p = 0.12, respectively).
CONCLUSION:
Our systematic review revealed that low-dose landiolol might help to prevent AF after cardiac surgery and further large trials are needed to evaluate safety because mortality and morbidity rate were very low in included studies.
麻醉学文献进展分享
联系我们