• European heart journal · Feb 2013

    Randomized Controlled Trial Multicenter Study Comparative Study

    Metoprolol vs. carvedilol or carvedilol plus N-acetyl cysteine on post-operative atrial fibrillation: a randomized, double-blind, placebo-controlled study.

    • Mehmet Ozaydin, Atilla Icli, Habil Yucel, Selahaddin Akcay, Oktay Peker, Dogan Erdogan, Ercan Varol, Abdullah Dogan, and Huseyin Okutan.
    • Department of Cardiology, Suleyman Demirel University, Kurtulus Mah, 122. Cad. no. 126/15, 32040, Isparta, Turkey. mehmetozaydin@hotmail.com
    • Eur. Heart J. 2013 Feb 1; 34 (8): 597-604.

    AimsCarvedilol and N-acetyl cysteine (NAC) have antioxidant and anti-inflammatory properties. Aim was to evaluate the efficacy of metoprolol, carvedilol, and carvedilol plus NAC on the prevention of post-operative atrial fibrillation (POAF).Methods And ResultsPatients undergoing cardiac surgery (n = 311) were randomized to metoprolol, carvedilol, or carvedilol plus NAC. Baseline characteristics were similar. The incidence of POAF was lower in the carvedilol plus NAC group compared with the metoprolol group (P < 0.0001) or the carvedilol group (P = 0.03). There was a borderline significance for lower POAF rates in the carvedilol group compared with the metoprolol group (P = 0.06). Duration of hospitalization was lower in the carvedilol plus NAC group compared to the metoprolol group (P = 0.004). Multivariate independent predictors of POAF included left-atrial diameter, hypertension, bypass duration, pre-randomization and pre-operative heart rates, carvedilol plus NAC group vs. metoprolol group, and carvedilol plus NAC group vs. carvedilol group.ConclusionCarvedilol plus NAC decreased POAF incidence and duration of hospitalization compared with metoprolol and decreased POAF incidence compared with carvedilol.

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