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Prevention of perioperative atrial fibrillation with betablockers in coronary surgery: betaxolol versus metoprolol

Domenii publicaţii > Ştiinţe medicale + Tipuri publicaţii > Articol în revistã ştiinţificã

Autori: Luminita Iliuta, Ruxandra Christodorescu, Daniela Filipescu, Horatiu Moldovan, Bogdan Radulescu, Rasvan Vasile

Editorial: Interactive CardioVascular and Thoracic Surgery, ISSN 1569-9285, Jul 2009; 9 , p.89-93, 2009.


In this study we tried to compare the efficacy and safety of betaxolol versus metoprolol immediately postoperatively in coronary artery bypass grafting patients and to determine whether prophylaxy for atrial fibrillation with betaxolol could reduce hospitalization and economic costs after cardiac surgery
Our trial was open-label, randomized, multicentric enrolling 1352 coronary surgery patients randomized to receive betaxolol or metoprolol. The primary endpoints were the composites of 30-day mortality, in-hospital atrial fibrillation (safety endpoints), duration of hospitalization and immobilization, quality of life, and the above endpoint plus in-hospital embolic event, bradycardia, gastrointestinal symptoms, sleep disturbances, cold extremities (efficacy plus safety endpoint).
At the end of the study the incidence and probability of early postoperative atrial fibrillation with betaxolol was lower than with metoprolol in coronary surgery (p<0,0001). In the two study groups minor side effects were similar and no major complication was reported (p<0,001). Patient compliance was good and the general condition improved due to shortened hospitalization and immobilization with subsequent improvement in the psychological status, less arrhythmias and lack of significant side effects. In conclusion, because of its efficacy and safety, betaxolol was superior to metoprolol for the prevention of the early postoperative atrial fibrillation in coronary surgery.

Cuvinte cheie: atrial fibrillation, coronary artery bypass grafting,betablockers