文献导读||胺钠酮加或不加N-乙酰半胱氨酸预防胸部手术后心房颤动

G within 7 days of surgery. Systemic markers of inflammation (interleukin-6, interleukin-8, tumor necrosis factor-α, C-reactive protein) and oxidative stress (F2-isoprostane prostaglandin PGF2α [8-iso-PGF2α], isofuran) were assessed immediately after surgery and on postoperative day 2.

Patients were phoned monthly to assess the occurrence of AF in year 1.

🌸Results: 🌸

Among 154 patients included, postoperative AF occurred in 15 of 78 who received N-acetylcysteine (19%) and 13 of 76 who received placebo (17%) (odds ratio, 1.24; 95.1% confidence interval, 0.53-2.88; p=0.615). The trial was stopped at the interim analysis because of futility. Three of the 28 patients with postoperative AF (11%) were discharged in AF. Regardless of treatment at 1 year, 7 of 28 patients with postoperative AF (25%) had recurrent episodes of AF. Inflammatory and oxidative stress markers were similar between groups.

🌸Conclusions: 🌸

Dual therapy comprising N-acetylcysteine plus amiodarone did not reduce the incidence of postoperative AF or markers of inflammation and oxidative stress early after major thoracic surgery, compared with amiodarone alone. Recurrent AF episodes are common among patients with postoperative AF within 1 year of major thoracic surgery.

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