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Published on: February 28, 2012
Incidence and Outcomes of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting of a Randomized
Ahmad Farouk Musa1,2, Jeswant Dillon3, Mohamed Ezani Md Taib3
1Jeffrey Cheah School of Medicine & Health Sciences, Monash University Malaysia, 47500 Subang Jaya, Selangor, Malaysia.
Insights
Postoperative atrial fibrillation (POAF) after coronary bypass grafting (CABG) is linked to increased mortality, renal failure, and longer hospital stays. Further research is needed to determine if Tocovid can reduce POAF incidence and its complications.
Area of Science:
- Cardiology
- Cardiac Surgery
- Clinical Trials
Background:
- Postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG).
- POAF is associated with adverse outcomes, including increased morbidity, mortality, and prolonged hospital stays.
- Understanding the incidence and impact of POAF is crucial for improving patient care after CABG.
Purpose of the Study:
- To analyze the incidence of POAF in patients undergoing CABG.
- To investigate the association between POAF and postoperative outcomes such as morbidity, mortality, and length of stay.
- To evaluate the potential of Tocovid as a treatment to reduce POAF and its sequelae.
Main Methods:
- A prospective, randomized, controlled trial was conducted.
- Patients were assigned to receive either Tocovid capsules or a placebo.
- Data collected included demographic information, postoperative outcomes, and length of stay in various hospital units.
Main Results:
- 35.2% of patients developed POAF post-CABG.
- POAF was significantly associated with increased mortality (p=0.01) and renal failure requiring dialysis (p=0.007).
- Patients with POAF experienced longer stays in the Cardiac Intensive Care Unit (CICU), High Dependency Unit (HDU), and overall hospital stay.
Conclusions:
- POAF significantly increases the risk of renal failure and death.
- POAF leads to extended CICU, HDU, and total hospital stays.
- The efficacy of Tocovid in preventing POAF and its complications requires further investigation.
Objective:
The objective of this study is to analyse the incidence of postoperative atrial fibrillation (POAF), demography, post-operative outcomes including morbidity and mortality, length of Cardiac Intensive Care Unit (CICU) stay, High Dependency Unit (HDU) stay, and total hospital stay in patients undergoing coronary bypass grafting (CABG) at Institut Jantung Negana (IJN).
Methods:
We conducted a prospective, randomised, controlled trial. We supplied the treatment group with Tocovid capsules and the control group with placebo containing palm superolein.
Results:
Since January 2019, we have recruited the target population of 250 patients. However, the result is still blinded as we are still analysing blood samples for tocotrienol levels. 89.2% of patients completed the study with a 3.6% mortality and a 7.6% attrition rate. 35.2% of the patients developed POAF, the mean time being 46.06 26.96 hours post-CABG. We did not observe any statistically significant difference when we compared left atrial size, New York Heart Association (NYHA) functional class, ejection fraction and premorbid history, besides EuroSCORE II (The European System for Cardiac Operative Risk Evaluation II) status except for older age group, right atrial size, and pleural effusion. There was also no difference in bypass time, cross clamp time or number of anastomoses. However, we noted a significant difference in death (p = 0.01) and renal failure requiring dialysis (p = 0.007) among patients with POAF; those patients also had a longer CICU stay (p = 0.005), HDU stay (p = 0.02), and total hospital stay (p = 0.001).
Conclusions:
POAF is associated with a higher incidence of renal failure and death while it increases CICU, HDU, and total hospital stay. It remains to be seen whether Tocovid reduces POAF and its associated sequelae.
Clinical Trial Registration:
NCT03807037 (Registered on 16 January 2019).
