Key result
Ivabradine compared to metoprolol resulted in a non-significant difference in postoperative atrial fibrillation (7.7% vs 11.9%) in patients undergoing off-pump CABG.
Why the study?
Does ivabradine compared to metoprolol reduce postoperative atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting?
Does ivabradine compared to metoprolol reduce postoperative atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting?
Absolute Event Rate: 7.7% vs 11.9%
Ivabradine and metoprolol demonstrate comparable efficacy in preventing postoperative atrial fibrillation in patients undergoing off-pump CABG.
Ivabradine offers no AF prevention advantage over metoprolol post-OPCABG; leaves open optimal rate-control strategies in this population.
INTRODUCTION: Classic coronary artery bypass grafting (CABG) surgery involves diastolic cardiac arrest under cardiopulmonary bypass, while off-pump CABG (OPCABG) has become widespread in recent years. METHODS: 174 patients who underwent OPCABG were included in the study. Patients were divided into two groups. Group I (n=90) received ivabradine and Group M (n=84) received metoprolol before surgery until postoperative day 10. Intraoperative arrhythmias and hypotension were recorded. Postoperative atrial fibrillation (AF) and arrhythmia, mortality and morbidity rates were assessed based on the 30-day postoperative follow-up. RESULTS: There were no significant differences in the intraoperative amount of inotropic support and red blood cell transfusion between groups (P=0.87 and P=0.31). However, the rates of intraoperative arrhythmias and hypotension were not significantly higher in Group M (P=0.317 and P=0.47). Ventricular tachycardia/ventricular fibrillation (VT/VF) was observed in 2 patients in both groups. Postoperative AF occurred in 7 patients (7.7%) in Group I and in 10 patients (11.9%) in Group M. Although there was a trend towards a higher prevalence of AF in Group M patients, this did not reach statistical significance. In addition, mortality and morbidity rates were comparable between groups.
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Tekin et al. (2022) studied Off-pump coronary artery bypass grafting (OPCABG) (n=174). Ivabradine vs. Metoprolol was evaluated on Postoperative atrial fibrillation (AF). Ivabradine compared to metoprolol resulted in a non-significant difference in postoperative atrial fibrillation (7.7% vs 11.9%) in patients undergoing off-pump CABG.
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