OP-191 LOW-DOSE AMIODARONE PROPHYLAXIS FOR PREVENTION OF POSTOPERATIVE ATRIAL FIBRILLATION: A PROSPECTIVE, DOUBLE-BLINDED, PLACEBO-CONTROLLED, RANDOMIZED STUDY

2013 ◽  
Vol 163 (3) ◽  
pp. S74-S75
Author(s):  
M.R. Sarzaeem ◽  
S. Sandoughdaran
Keyword(s):  
Atrial Fibrillation ◽  
Low Dose ◽  
Randomized Study ◽  
Postoperative Atrial Fibrillation ◽  
Double Blinded

scholarly journals Spontaneous Preterm Birth: Is Prevention with Aspirin Possible?

2021 ◽  
Author(s):  
Richard Berger ◽  
Ioannis Kyvernitakis ◽  
Holger Maul
Keyword(s):  
Preterm Birth ◽  
Low Dose ◽  
Randomized Study ◽  
Preterm Births ◽  
Spontaneous Preterm Birth ◽  
Dose Aspirin ◽  
Nulliparous Women ◽  
Low Dose Aspirin ◽  
Secondary Analyses ◽  
Double Blinded

Abstract Background The rate of preterm births in Germany is 8.6%, which is very high compared to other European countries. As preterm birth contributes significantly to perinatal morbidity and mortality rates, the existing prevention strategies need to be optimized and expanded further. About ⅔ of all women with preterm birth have preterm labor or premature rupture of membranes. They are bracketed together under the term “spontaneous preterm birth” as opposed to iatrogenic preterm birth, for example as a consequence of preeclampsia or fetal growth retardation. Recent studies suggest that low-dose aspirin does not just reduce the rate of iatrogenic preterm births but can also further reduce the rate of spontaneous preterm births. This review article presents the current state of knowledge. Method A selective literature search up until April 2020 was done in PubMed, using the terms “randomized trial”, “randomized study”, “spontaneous preterm birth”, and “aspirin”. Results Secondary analyses of prospective randomized studies on the prevention of preeclampsia with low-dose aspirin show that this intervention also significantly reduced the rate of spontaneous preterm births in both high-risk and low-risk patient populations. The results of the ASPIRIN trial, a prospective, randomized, double-blinded multicenter study carried out in six developing countries, also point in this direction, with the figures showing that the daily administration of 81 mg aspirin starting before 14 weeks of gestation lowered the preterm birth rate of nulliparous women without prior medical conditions by around 11% (11.6 vs. 13.1%; RR 0.89; 95% CI: 0.81 – 0.98, p = 0.012). Conclusion Further studies on this issue are urgently needed. If these confirm the currently available results, then it would be worth discussing whether general aspirin prophylaxis for all pregnant women starting at the latest in 12 weeks of gestation is indicated.

scholarly journals Perioperative Intravenous Amiodarone Does Not Reduce the Burden of Atrial Fibrillation in Patients Undergoing Cardiac Valvular Surgery

2010 ◽  
Vol 112 (1) ◽  
pp. 128-137 ◽  
Author(s):  
Yanick Beaulieu ◽  
André Y. Denault ◽  
Pierre Couture ◽  
Denis Roy ◽  
Mario Talajic ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Channel Blocker ◽  
Controlled Trial ◽  
Postoperative Atrial Fibrillation ◽  
Common Complication ◽  
Randomized Controlled ◽  
Valvular Surgery ◽  
Intravenous Amiodarone ◽  
Double Blinded ◽  
Preoperative Factors

Background Atrial fibrillation is a common complication after cardiac surgery. Postoperative atrial fibrillation is associated with increased risks of morbidity and mortality, and, therefore, preventive strategies using oral amiodarone have been developed but are often unpractical. Intravenous amiodarone administered after the induction of anesthesia and continued postoperatively for 48 h could represent an effective strategy to prevent postoperative atrial fibrillation in patients undergoing cardiac valvular surgery. Methods Single-center, double-blinded, double-dummy, randomized controlled trial in patients undergoing valvular surgery. Patients received either an intravenous loading dose of 300 mg of amiodarone or placebo in the operating room, followed by a perfusion of 15 mg . kg(-1) . 24 h(-1) for 2 days. The primary endpoint was the development of atrial fibrillation occurring at any time within the postoperative period. Results One hundred twenty patients were randomly assigned (mean age was 65 +/- 11 yr). Overall atrial fibrillation occurred more frequently in the perioperative intravenous amiodarone group compared with the placebo group (59.3 vs. 40.0%; P = 0.035). Four preoperative factors were found to be independently associated with a higher risk of developing postoperative atrial fibrillation: older age (P = 0.0003), recent myocardial infarction (<6 months; P = 0.026), preoperative angina (P = 0.0326), and use of a calcium channel blocker preoperatively (P = 0.0078) when controlling for groups. Conclusion In patients undergoing cardiac valvular surgery, a strategy using intravenous amiodarone for 48 h is not efficacious in reducing the risk of atrial fibrillation during cardiac valvular surgery.

scholarly journals Preventive effect of low-dose landiolol on postoperative atrial fibrillation study (PELTA study)

2020 ◽  
Vol 68 (11) ◽  
pp. 1240-1251 ◽  
Author(s):  
Konosuke Sasaki ◽  
Kiichiro Kumagai ◽  
Kay Maeda ◽  
Masatoshi Akiyama ◽  
Koki Ito ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Low Dose ◽  
Cardiovascular Surgery ◽  
Multivariate Logistic Regression Analysis ◽  
Postoperative Atrial Fibrillation ◽  
Control Group ◽  
Angiotensin Ii Receptor ◽  
Prophylactic Administration ◽  
Valvular Surgery ◽  
Landiolol Hydrochloride

Abstract Objective To investigate the efficacy of prophylactic administration of low-dose landiolol on postoperative atrial fibrillation (POAF) in patients after cardiovascular surgery. Methods Consecutive 150 patients over 70 years of age who underwent cardiovascular surgery for valvular, ischemic heart, and aortic diseases were enrolled in this single-center prospective randomized control study from 2010 to 2014. They were assigned to three treatment groups: 1γ group (landiolol at 1 μg/kg/min), 2γ group (landiolol at 2 μg/kg/min), or control group (no landiolol). In the two landiolol groups, landiolol hydrochloride was intravenously administered for a period of 4 days postoperatively. Electrocardiography was continuously monitored during the study period, and cardiologists eventually assessed whether POAF occurred or not. Results POAF occurred in 24.4% of patients in the control group, 18.2% in 1γ group, and 11.1% in 2γ group (p = 0.256). Multivariate logistic regression analysis showed that the incidence of POAF tended to decrease depending on the dose of landiolol (trend-p = 0.120; 1γ group: OR = 0.786, 95% CI 0.257–2.404; 2γ group: OR = 0.379, 95% CI 0.112–1.287). Subgroup analysis showed a significant dose-dependent reduction in POAF among categories of female sex, non-use of angiotensin II receptor blockers (ARBs) before surgery, and valve surgery (each trend-p = 0.02, 0.03, and 0.004). Conclusions These findings indicate that prophylactic administration of low-dose landiolol may not be effective for preventing the occurrence of POAF in overall patients after cardiovascular surgery, but the administration could be beneficial to female patients, patients not using ARBs preoperatively, and those after valvular surgery.

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