Key result
Perioperative administration of landiolol hydrochloride significantly reduced the occurrence of atrial fibrillation after cardiothoracic surgery compared to control (11% vs 25%; OR 0.32).
Why the study?
The study was conducted to assess the benefit of perioperative intravenous landiolol hydrochloride in preventing atrial fibrillation after cardiothoracic surgery.
Does perioperative intravenous landiolol hydrochloride prevent postoperative atrial fibrillation in patients undergoing cardiothoracic surgery?
Meta-Analysis (n=1,349)
Does perioperative intravenous landiolol hydrochloride prevent postoperative atrial fibrillation in patients undergoing cardiothoracic surgery?
Odds Ratio: 0.32 (95% CI 0.23–0.43)
Absolute Event Rate: 11% vs 25%
p-value: p=<0.00001
Perioperative intravenous landiolol significantly reduces the incidence of postoperative atrial fibrillation and complications following cardiothoracic surgery.
Supports perioperative landiolol for POAF prevention; strengthens RCT evidence base without added complications.
OBJECTIVE: The purpose of this article was to assess the benefit of perioperative administration of the intravenous beta-blocker landiolol hydrochloride in preventing atrial fibrillation (AF) after cardiothoracic surgery. METHODS: We performed a systematic search in PubMed, Web of Science, CNKI, and OVID to identify randomized controlled trials (RCTs) and cohorts up to January 2021. Data regarding postoperative atrial fibrillation (POAF) and safety outcomes were extracted. Odds ratios (ORs) with 95% confidence intervals (CIs) were determined using the Mantel-Haenszel method. Meanwhile, subgroup analyses were conducted according to surgery type including lung cancer surgery, esophageal cancer surgery, and cardiac surgery. RESULTS: Seventeen eligible articles involving 1349 patients within 13 RCTs and four cohorts were included in our meta-analysis. Compared with control group, landiolol administration was associated with a significant reduction of the occurrence of AF after cardiothoracic surgery (OR = 0.32, 95% CI 0.23-0.43, P <0.00001). In addition, the results demonstrated that perioperative administration of landiolol hydrochloride minimized the occurrence of postoperative complications (OR = 0.48, 95% CI 0.33-0.70, P = 0.0002). Funnel plots indicated no obvious publication bias. CONCLUSIONS: Considering this analysis, landiolol was effective in the prevention of AF after cardiothoracic surgery and did not increase the risk of major postoperative complications.
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Hao et al. (2021) conducted a meta-analysis in Postoperative atrial fibrillation following cardiothoracic surgery (n=1,349). Landiolol hydrochloride vs. Control was evaluated on Incidence of atrial fibrillation occurring during the 7 days after cardiothoracic surgery (OR 0.32, 95% CI 0.23-0.43, p=<0.00001). Perioperative administration of landiolol hydrochloride significantly reduced the occurrence of atrial fibrillation after cardiothoracic surgery compared to control (11% vs 25%; OR 0.32).
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