Document Detail


The combination of propranolol and magnesium does not prevent postoperative atrial fibrillation.
MedLine Citation:
PMID:  10654500     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atrial fibrillation is a common complication of cardiovascular surgery. Beta-blockers have been shown to decrease the incidence of postoperative atrial fibrillation. However, the use of magnesium is more controversial. It was our hypothesis that adjunctive magnesium sulfate would improve the efficacy of beta-blockers alone in the prevention of postoperative atrial fibrillation. METHODS: We prospectively randomized 167 coronary artery bypass patients (mean age 61+/-10 years, 115 men) to receive propranolol alone (20 mg four times daily) or propranolol and magnesium (18 g over 24 hours). Magnesium was begun intraoperatively, and propranolol was started on admission to the intensive care unit. RESULTS: Using an intention-to-treat analysis, the incidence of postoperative atrial fibrillation was 19.5% in the propranolol-treated patients and 22.4% in propranolol + magnesium-treated patients (p = 0.65). Because combination therapy resulted in an excess of postoperative hypotension, which required withholding doses of propranolol, an on-treatment analysis was also performed. In this analysis, the incidence of atrial fibrillation was still not significantly different (18.5% in propranolol-treated patients and 10.0% in propranolol + magnesium-treated patients, p = 0.20). CONCLUSIONS: Adjunctive magnesium sulfate, in combination with propranolol, does not decrease the incidence of postoperative atrial fibrillation.
Authors:
A J Solomon; A K Berger; K K Trivedi; R L Hannan; N M Katz
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  69     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-17     Completed Date:  2000-02-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  126-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Georgetown University Medical Center, Washington, DC 20007, USA. solomona@gunet.georgetown.edu
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adrenergic beta-Antagonists / administration & dosage,  adverse effects,  therapeutic use*
Anti-Arrhythmia Agents / administration & dosage,  adverse effects,  therapeutic use*
Atrial Fibrillation / prevention & control*
Coronary Artery Bypass
Drug Therapy, Combination
Female
Heart Rate / drug effects
Humans
Hypotension / chemically induced
Incidence
Infusions, Intravenous
Intraoperative Care
Length of Stay
Magnesium Sulfate / administration & dosage,  adverse effects,  therapeutic use*
Male
Middle Aged
Postoperative Complications / chemically induced,  prevention & control*
Propranolol / administration & dosage,  adverse effects,  therapeutic use*
Prospective Studies
Single-Blind Method
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Anti-Arrhythmia Agents; 525-66-6/Propranolol; 7487-88-9/Magnesium Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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