RESEARCH ARTICLE


Bisoprolol Versus Corticosteroid and Bisoprolol Combination for Prevention of Atrial Fibrillation After On-Pump Coronary Artery Bypass Graft Surgery



Ramy Mahrose1, *, Ahmed M. Elsayed, Mohamed S. Elshorbagy
1 Department of Anesthesiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt


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Creative Commons License
© 2019 Mahrose et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Anesthesiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Tel: +201281431097; Email: ramymahrose2@gmail.com


Abstract

Background:

The most common cardiac arrhythmia that happens after on-pump Coronary Artery Bypass Graft (CABG) surgery is Atrial Fibrillation (AF). It is combined with several postoperative complications such as increased incidence of stroke, increased hospital stay and increased costs.

Objectives:

The aim of this study was to look for safe, effective, reliable and well tolerated tools for the prevention of atrial fibrillation after on pump coronary artery bypass surgery.

Patients and Methods:

The study enclosed 176 patients (the age ranges from 40 to 79 years) and scheduled for elective on-pump CABG operations without concomitant procedures. The patients were selected randomly into two equal groups. Group (A) in which bisoprolol was used to prevent atrial fibrillation after surgery. Group (B) in which bisoprolol and hydrocortisone were used for prevention of atrial fibrillation after surgery. For each patient, the following data were collected: gender, preoperative diseases, cardiopulmonary bypass time, intraoperative cross clamp time, Left internal mammary Artery usage, incidence of postoperative atrial fibrillation, death, myocardial infarction chest infection and C-reactive protein amount in plasma.

Results:

There was a statistically significant decrease in the occurrence of atrial fibrillation in group (B) when compared to corresponding values in group (A). Also, group (B) showed a statistically significant decrease in length of hospital stay in comparison to group (A). C-reactive protein concentrations on the 1st and 2nd postoperative days were lower significantly in group (B) than in group (A). There were no statistically significant differences between both groups regarding gender, preoperative diseases, cardiorespiratory bypass time, intraoperative cross clamp time, Left internal mammary artery usage, death, myocardial infarction and chest infection.

Conclusion:

This study demonstrated that using bisoprolol and hydrocortisone combination showed greater benefit than the use of bisoprolol only for prevention of postoperative AF after on-pump coronary artery bypass graft surgery.

Keywords: Bisoprolol, Corticosteroid, Atrial fibrillation, Cardiac surgery, Myocardial infarction, Bypass graft surgery.