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Meta-Analysis
. 2013 Jan 23;13:5.
doi: 10.1186/1471-2261-13-5.

Meta-analysis of Randomized Controlled Trials on Magnesium in Addition to Beta-Blocker for Prevention of Postoperative Atrial Arrhythmias After Coronary Artery Bypass Grafting

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Free PMC article
Meta-Analysis

Meta-analysis of Randomized Controlled Trials on Magnesium in Addition to Beta-Blocker for Prevention of Postoperative Atrial Arrhythmias After Coronary Artery Bypass Grafting

Xiaosan Wu et al. BMC Cardiovasc Disord. .
Free PMC article

Abstract

Background: Atrial arrhythmia (AA) is the most common complication after coronary artery bypass grafting (CABG). Only beta-blockers and amiodarone have been convincingly shown to decrease its incidence. The effectiveness of magnesium on this complication is still controversial. This meta-analysis was performed to evaluate the effect of magnesium as a sole or adjuvant agent in addition to beta-blocker on suppressing postoperative AA after CABG.

Methods: We searched the PubMed, Medline, ISI Web of Knowledge, Cochrane library databases and online clinical trial database up to May 2012. We used random effects model when there was significant heterogeneity between trials and fixed effects model when heterogeneity was negligible.

Results: Five randomized controlled trials were identified, enrolling a total of 1251 patients. The combination of magnesium and beta-blocker did not significantly decrease the incidence of postoperative AA after CABG versus beta-blocker alone (odds ratio (OR) 1.12, 95% confidence interval (CI) 0.86-1.47, P = 0.40). Magnesium in addition to beta-blocker did not significantly affect LOS (weighted mean difference -0.14 days of stay, 95% CI -0.58 to 0.29, P = 0.24) or the overall mortality (OR 0.59, 95% CI 0.08-4.56, P = 0.62). However the risk of postoperative adverse events was higher in the combination of magnesium and beta-blocker group than beta-blocker alone (OR 2.80, 95% CI 1.66-4.71, P = 0.0001).

Conclusions: This meta-analysis offers the more definitive evidence against the prophylactic administration of intravenous magnesium for prevention of AA after CABG when beta-blockers are routinely administered, and shows an association with more adverse events in those people who received magnesium.

Figures

Figure 1
Figure 1
Summary of study selection and exclusion process.
Figure 2
Figure 2
Forest plot showing the incidence of postoperative AA after CABG. Values are given as the odds ratio [95% confidence interval (CI)] as determined by the fixed effects model. Mag: magnesium; BB: beta-blocker.
Figure 3
Figure 3
Forest plot showing the effect on hospital LOS (days) after CABG. Values are given as the mean difference [95% confidence interval (CI)] as determined by the fixed effects model. Mag: magnesium; BB: beta-blocker.
Figure 4
Figure 4
Forest plot showing the adverse events following CABG. Values are given as the odds ratio [95% confidence interval (CI)] as determined by the fixed effects model. Mag: magnesium; BB: beta-blocker.
Figure 5
Figure 5
Forest plot showing the incidence of POAT after CABG. Values are given as the odds ratio [95% confidence interval (CI)] as determined by the fixed effects model. Mag: magnesium; BB: beta-blocker.

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References

    1. Ommen SR, Odell JA, Stanton MS. Atrial arrhythmias after cardiothoracic surgery. N Engl J Med. 1997;336:1429–1434. doi: 10.1056/NEJM199705153362006. - DOI - PubMed
    1. Kim MH, Deeb GM, Morady F, Bruckman D, Hallock LR, Smith KA, Karavite DJ, Bolling SF, Pagani FD, Wahr JA, Sonnad SS, Kazanjian PE, Watts C, Williams M, Eagle KA. Effect of postoperative atrial fibrillation on length of stay after cardiac surgery (The Postoperative Atrial Fibrillation in Cardiac Surgery study [PACS(2)] Am J Cardiol. 2001;87:881–885. doi: 10.1016/S0002-9149(00)01530-7. - DOI - PubMed
    1. Lahtinen J, Biancari F, Salmela E, Mosorin M, Satta J, Rainio P, Rimpiläinen J, Lepojärvi M, Juvonen T. Postoperative atrial fibrillation is a major cause of stroke after on-pump coronary artery bypass surgery. Ann Thorac Surg. 2004;77:1241–1244. doi: 10.1016/j.athoracsur.2003.09.077. - DOI - PubMed
    1. Andrews TC, Reimold SC, Berlin JA, Antman EM. Prevention of supraventricular arrhythmias after coronary artery bypass surgery. A meta-analysisof randomized control trials. Circulation. 1991;84(Suppl III):236–244. - PubMed
    1. Daoud EG, Strickberger SA, Man KC, Goyal R, Deeb GM, Bolling SF, Pagani FD, Bitar C, Meissner MD. Morady F:Preoperative amiodarone as prophylaxis against atrial fibrillation after heart surgery. N Engl J Med. 1997;337:1785–1791. doi: 10.1056/NEJM199712183372501. - DOI - PubMed

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