We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Corticosteroids for the prevention of atrial fibrillation after cardiac surgery: a randomized controlled trial.
- Authors
Halonen J; Halonen P; Järvinen O; Taskinen P; Auvinen T; Tarkka M; Hippeläinen M; Juvonen T; Hartikainen J; Hakala T; Halonen, Jari; Halonen, Pirjo; Järvinen, Otso; Taskinen, Panu; Auvinen, Tommi; Tarkka, Matti; Hippeläinen, Mikko; Juvonen, Tatu; Hartikainen, Juha; Hakala, Tapio
- Abstract
<bold>Context: </bold>Atrial fibrillation (AF) is the most common arrhythmia to occur after cardiac surgery. An exaggerated inflammatory response has been proposed to be one etiological factor.<bold>Objective: </bold>To test whether intravenous corticosteroid administration after cardiac surgery prevents AF after cardiac surgery.<bold>Design, Setting, and Patients: </bold>A double-blind, randomized multicenter trial (study enrollment August 2005-June 2006) in 3 university hospitals in Finland of 241 consecutive patients without prior AF or flutter and scheduled to undergo first on-pump coronary artery bypass graft (CABG) surgery, aortic valve replacement, or combined CABG surgery and aortic valve replacement.<bold>Intervention: </bold>Patients were randomized to receive either 100-mg hydrocortisone or matching placebo as follows: the first dose in the evening of the operative day, then 1 dose every 8 hours during the next 3 days. In addition, all patients received oral metoprolol (50-150 mg/d) titrated to heart rate.<bold>Main Outcome Measure: </bold>Occurrence of AF during the first 84 hours after cardiac surgery.<bold>Results: </bold>The incidence of postoperative AF was significantly lower in the hydrocortisone group (36/120 [30%]) than in the placebo group (58/121 [48%]; adjusted hazard ratio, 0.54; 95% confidence interval, 0.35-0.83; P = .004; number needed to treat, 5.6). Compared with placebo, patients receiving hydrocortisone did not have higher rates of superficial or deep wound infections, or other major complications.<bold>Conclusion: </bold>Intravenous hydrocortisone reduced the incidence of AF after cardiac surgery.<bold>Trial Registration: </bold>clinicaltrials.gov Identifier: NCT00442494.
- Publication
JAMA: Journal of the American Medical Association, 2007, Vol 297, Issue 14, p1562
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.297.14.1562