Preoperative Antihypertensive Medication in Relation to Postoperative Atrial Fibrillation in Patients Undergoing...

Area of Science:

• Cardiology
• Pharmacology
• Clinical Medicine

Background:

• Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery.
• Preoperative hypertension and the use of antihypertensive medications are potential risk factors for POAF.

Purpose of the Study:

• To systematically review and meta-analyze the association between preoperative hypertension, specific antihypertensive drug classes, and the incidence of POAF in cardiac surgery patients.
• To evaluate the impact of preoperative calcium antagonists, ACE inhibitors, and beta-blockers on POAF risk.

Main Methods:

• Systematic literature search of PubMed, Embase, and Cochrane Library up to March 2016.
• Meta-analysis of 25 trials including 130,087 patients to calculate pooled risk ratios (OR) and 95% confidence intervals (CIs).
• Subgroup analysis was performed, including a focus on Asian patients.

Main Results:

• Preoperative hypertension was significantly associated with a higher incidence of POAF (P < 0.05).
• Preoperative use of calcium antagonists and ACE inhibitors was also linked to a higher POAF risk (P < 0.05).
• No significant difference in POAF risk was observed for preoperative beta-blocker use (P = 0.08).

Conclusions:

• Preoperative hypertension appears to be a significant risk factor for developing POAF after cardiac surgery.
• Certain preoperative antihypertensive medications, specifically calcium antagonists and ACE inhibitors, may also be associated with an increased risk of POAF.
• Further research may be needed to clarify the role of specific antihypertensive agents and to address ethnic variations observed in subgroup analyses.