Abstract
BackgroundPostoperative atrial fibrillation (POAF) is the most common complication after coronary artery bypass grafting (CABG). The preventive effect of magnesium on POAF is not well known. This meta-analysis was undertaken to assess the efficacy of intravenous magnesium on the prevention of POAF after CABG.MethodsEligible studies were identified from electronic databases (Medline, Embase, and the Cochrane Library). The primary outcome measure was the incidence of POAF. The meta-analysis was performed with the fixed-effect model or random-effect model according to heterogeneity.ResultsSeven double-blind, placebo-controlled, randomized clinical trials met the inclusion criteria including 1,028 participants. The pooled results showed that intravenous magnesium reduced the incidence of POAF by 36% (RR 0.64; 95% confidence interval (CI) 0.50-0.83; P = 0.001; with no heterogeneity between trials (heterogeneity P = 0.8, I2 = 0%)).ConclusionsThis meta-analysis indicates that intravenous magnesium significantly reduces the incidence of POAF after CABG. This finding encourages the use of intravenous magnesium as an alternative to prevent POAF after CABG. But more high quality randomized clinical trials are still need to confirm the safety.
Highlights
Postoperative atrial fibrillation (POAF) is the most common complication encountered following coronary artery bypass grafting (CABG)
The incidence of atrial fibrillation after CABG reported in previous studies varies from 10% to 50% [1,2,4], and this incidence has not decreased despite improvements in anesthetic and surgical techniques [5,6]
The analysis showed that intravenous magnesium is associated with a significant reduction in the incidence of atrial fibrillation after CABG, with a relative risk of 0.64 (95% confidence interval (CI) 0.47-0.87)
Summary
Postoperative atrial fibrillation (POAF) is the most common complication encountered following coronary artery bypass grafting (CABG). It generally occurs between 24 and 96 h postoperatively, with a peak incidence on the second postoperative day [1,2,3]. The cause may be multifactorial, such as advanced age, previous history of atrial fibrillation, and low blood magnesium concentrations [11,12,13]. Magnesium seems to be with great promise to prevent POAF following CABG. Postoperative atrial fibrillation (POAF) is the most common complication after coronary artery bypass grafting (CABG). The preventive effect of magnesium on POAF is not well known.
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