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Comparing the therapeutic effects of carvedilol and metoprolol on prevention of atrial fibrillation after coronary artery bypass surgery, a double-blind study.

Jalalian R, Ghafari R, Ghazanfari P - Int Cardiovasc Res J (2014)

Bottom Line: The results of Fisher Exact test showed no significant relationship between the type of the drug and the occurrence of AF (P < 0.05).However, no significant difference was found between the two groups in this regard.Yet, given the anti-oxidant and anti- inflammatory effects of carvedilol, it might be more beneficial in comparison to metoprolol, particularly in the patients with lower ejection fractions or heart failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.

ABSTRACT

Background: Atrial Fibrillation (AF) is a common complication after open heart surgery and is frequently associated with increased hospital stay, complications, and mortality rates. The effect of β-blockers on prevention of supraventricular arrhythmias has been confirmed in several prospective randomized studies.

Objectives: This clinical trial aimed to compare the preventive effects of carvedilol and metoprolol on occurrence of AF after CABG surgery.

Patients and methods: This prospective, double-blind, randomized clinical trial was conducted on 150 patients (55 females, 95 males; mean age: 59 ± 10 years) who underwent CABG surgery. The patients with no contraindication for β-blocker use were randomly divided into two groups of carvedilol and metoprolol Tartarate (n = 75). Treatment with β-blocker was started on the first postoperative day (metoprolol, 25 mg BD; carvedilol, 6.25 mg, BD) and the dosage was regulated according to the patients' hemodynamic response. All the patients were monitored 5 days after the surgery and incidence of AF and other complications was recorded in both groups.

Results: AF was detected in 18 patients in the carvedilol group and 21 patients in the metoprolol group (P = 0.577). The results of Fisher Exact test showed no significant relationship between the type of the drug and the occurrence of AF (P < 0.05). Nevertheless, the prevalence of AF was higher in the renal failure group. AF was mostly recorded on the second and third days after the surgery. The results showed an association between old age and higher occurrence of AF. AF was recorded in 11 patients (14%) in the metoprolol group and 9 ones (12%) in the carvedilol group, with Left Ventricle Ejection Fraction (LVEF) being between 35% and 45% (P = 0.587). However, no significant difference was found between the two groups in this regard.

Conclusions: In the patients with sufficient ejection fraction, no difference was observed in using carvedilol or metoprolol in prevention of post-CABG AF. Yet, given the anti-oxidant and anti- inflammatory effects of carvedilol, it might be more beneficial in comparison to metoprolol, particularly in the patients with lower ejection fractions or heart failure.

No MeSH data available.


Related in: MedlinePlus

Post-Operative Arrhythmia in Carvedilol and Metoprolol Groups
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fig11915: Post-Operative Arrhythmia in Carvedilol and Metoprolol Groups

Mentions: Occurrence of atrial and ventricular fibrillation and maximum heart rate were recorded for both groups. Atrial fibrillation was seen in 18 patients in the carvedilol group and 21 ones in the metoprolol group (P = 0.577) (Figure 1). The results of Fisher exact test showed no significant relationship between the type of drug and occurrence of AF (Table 3). The highest prevalence of AF was recorded on the second and third days after the surgery; 24 patients had AF on the second post-operative day (9 in the carvedilol group and 15 in the metoprolol group) and 12 patients developed AF on the third day after the surgery (8 in the carvedilol group and 4 in the metoprolol group) (Table 4).


Comparing the therapeutic effects of carvedilol and metoprolol on prevention of atrial fibrillation after coronary artery bypass surgery, a double-blind study.

Jalalian R, Ghafari R, Ghazanfari P - Int Cardiovasc Res J (2014)

Post-Operative Arrhythmia in Carvedilol and Metoprolol Groups
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109035&req=5

fig11915: Post-Operative Arrhythmia in Carvedilol and Metoprolol Groups
Mentions: Occurrence of atrial and ventricular fibrillation and maximum heart rate were recorded for both groups. Atrial fibrillation was seen in 18 patients in the carvedilol group and 21 ones in the metoprolol group (P = 0.577) (Figure 1). The results of Fisher exact test showed no significant relationship between the type of drug and occurrence of AF (Table 3). The highest prevalence of AF was recorded on the second and third days after the surgery; 24 patients had AF on the second post-operative day (9 in the carvedilol group and 15 in the metoprolol group) and 12 patients developed AF on the third day after the surgery (8 in the carvedilol group and 4 in the metoprolol group) (Table 4).

Bottom Line: The results of Fisher Exact test showed no significant relationship between the type of the drug and the occurrence of AF (P < 0.05).However, no significant difference was found between the two groups in this regard.Yet, given the anti-oxidant and anti- inflammatory effects of carvedilol, it might be more beneficial in comparison to metoprolol, particularly in the patients with lower ejection fractions or heart failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.

ABSTRACT

Background: Atrial Fibrillation (AF) is a common complication after open heart surgery and is frequently associated with increased hospital stay, complications, and mortality rates. The effect of β-blockers on prevention of supraventricular arrhythmias has been confirmed in several prospective randomized studies.

Objectives: This clinical trial aimed to compare the preventive effects of carvedilol and metoprolol on occurrence of AF after CABG surgery.

Patients and methods: This prospective, double-blind, randomized clinical trial was conducted on 150 patients (55 females, 95 males; mean age: 59 ± 10 years) who underwent CABG surgery. The patients with no contraindication for β-blocker use were randomly divided into two groups of carvedilol and metoprolol Tartarate (n = 75). Treatment with β-blocker was started on the first postoperative day (metoprolol, 25 mg BD; carvedilol, 6.25 mg, BD) and the dosage was regulated according to the patients' hemodynamic response. All the patients were monitored 5 days after the surgery and incidence of AF and other complications was recorded in both groups.

Results: AF was detected in 18 patients in the carvedilol group and 21 patients in the metoprolol group (P = 0.577). The results of Fisher Exact test showed no significant relationship between the type of the drug and the occurrence of AF (P < 0.05). Nevertheless, the prevalence of AF was higher in the renal failure group. AF was mostly recorded on the second and third days after the surgery. The results showed an association between old age and higher occurrence of AF. AF was recorded in 11 patients (14%) in the metoprolol group and 9 ones (12%) in the carvedilol group, with Left Ventricle Ejection Fraction (LVEF) being between 35% and 45% (P = 0.587). However, no significant difference was found between the two groups in this regard.

Conclusions: In the patients with sufficient ejection fraction, no difference was observed in using carvedilol or metoprolol in prevention of post-CABG AF. Yet, given the anti-oxidant and anti- inflammatory effects of carvedilol, it might be more beneficial in comparison to metoprolol, particularly in the patients with lower ejection fractions or heart failure.

No MeSH data available.


Related in: MedlinePlus