Comparing the efficacy of N-acetylcysteine plus carvedilol versus carvedilol in the prevention of atrial fibrillation following coronary artery bypass graft surgery.

Rozita Jalalian, Mahsa Maleki, Rahman Ghafari, Valiollah Habibi, Saman Heydari, Mohammadreza Iranian

Journal: Journal of cardiac surgery 2023;37(12):4698-4704

PMID: 36285551

Abstract

BACKGROUND

Atrial fibrillation (AF) is the most common arrhythmia following open-heart surgery. Agents with antioxidant properties may reduce postoperative complications like postoperative AF (POAF) in patients undergoing open-heart surgery. This study was conducted to assess the effect of N-acetylcysteine (NAC) in prevention of AF following coronary artery bypass graft (CABG) surgery.

METHODS

Three hundred patients who underwent CABG surgery were entered in the study. Patients with contraindications for beta-blockers and patients were simultaneously replacing or repairing the valve with open-heart surgery were excluded. The patients were randomly divided into two groups (n = 150) and they were received NAC plus carvedilol or carvedilol. The patients were monitored for 5 days after surgery and the incidence of AF during hospitalization was recorded.

RESULTS

AF was detected in 14 patients in the NAC with Carvedilol group (9.33%) and 23 patients in Carvedilol group (15.33%). There was no significant difference in the incidence of POAF between the two groups (p value = 0.112). The result of multivariable regression model represented that although the incidence of POAF was lower in NAC plus carvedilol group, it wasn't statistically significant (p value = 0.10).

CONCLUSIONS

NAC was not associated with a decreased incidence of AF following CABG surgery.

© 2022 Wiley Periodicals LLC.

Address: Department of Cardiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Department of Cardiac Surgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.; Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.; Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Science, Tehran, Iran.
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