Key result
Postoperative atrial fibrillation occurred in 35.2% of patients undergoing coronary artery bypass grafting and was significantly associated with increased mortality, renal failure, and longer hospital stays.
Why the study?
To analyse the incidence of postoperative atrial fibrillation, demography, and postoperative outcomes including morbidity, mortality, and hospital stay in patients undergoing CABG.
Does tocotrienol and tocopherol supplementation reduce postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting?
RCT (n=250)
Double-blind
Computer-generated randomisation programme
No
Does tocotrienol and tocopherol supplementation reduce postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting?
Postoperative atrial fibrillation is a frequent complication of CABG that is significantly associated with increased mortality, renal failure, and prolonged intensive care and hospital stays.
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).
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Musa et al. (2022) conducted an RCT in Postoperative atrial fibrillation (n=250). Tocovid vs. Placebo containing palm superolein was evaluated on Postoperative atrial fibrillation (POAF) occurrence. Postoperative atrial fibrillation occurred in 35.2% of patients undergoing coronary artery bypass grafting and was significantly associated with increased mortality, renal failure, and longer hospital stays.
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