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N-3 Fatty Acids for the Prevention of Atrial Fibrillation After Coronary Artery Bypass Surgery: A Randomized, Controlled Trial

https://doi.org/10.1016/j.jacc.2005.02.079Get rights and content
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Objectives

The aim of this study was to assess the efficacy of preoperative and postoperative treatment with n-3 polyunsaturated fatty acids (PUFAs) in preventing the occurrence of atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG).

Background

Postoperative AF is a common complication of CABG. There is growing clinical evidence that PUFAs have cardiac antiarrhythmic effects.

Methods

A total of 160 patients were prospectively randomized to a control group (81 patients, 13 female, 64.9 ± 9.1 years) or PUFAs 2 g/day (79 patients, 11 female, 66.2 ± 8.0 years) for at least 5 days before elective CABG and until the day of discharge from the hospital. The primary end point was the development of AF in the postoperative period. The secondary end point was the hospital length of stay after surgery. All end points were independently adjudicated by two cardiologists blinded to treatment assignment.

Results

The clinical and surgical characteristics of the patients in the two groups were similar. Postoperative AF developed in 27 patients of the control group (33.3%) and in 12 patients of the PUFA group (15.2%) (p = 0.013). There was no significant difference in the incidence of nonfatal postoperative complications, and postoperative mortality was similar in the PUFA-treated patients (1.3%) versus controls (2.5%). After CABG, the PUFA patients were hospitalized for significantly fewer days than controls (7.3 ± 2.1 days vs. 8.2 ± 2.6 days, p = 0.017).

Conclusions

This study first demonstrates that PUFA administration during hospitalization in patients undergoing CABG substantially reduced the incidence of postoperative AF (54.4%) and was associated with a shorter hospital stay.

Abbreviations and Acronyms

AF
atrial fibrillation
CABG
coronary artery bypass graft surgery
CI
confidence interval
DHA
docosahexaenoic acid
EPA
eicosapentaenoic acid
OR
odds ratio
PUFA
n-3 polyunsaturated fatty acid

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