[Effect of dexamethasone on atrial fibrillation after cardiac surgery: a meta-analysis]. 2010

Kang Yi, and Jin-Hui Tian, and Bin Zhang, and Bing Song, and Ke-Hu Yang
The Evidence-based Medicine Center of Lanzhou University, Lanzhou 730000, China.

OBJECTIVE To assess the effect of preoperative dexamethasone on the occurrence of postoperative atrial fibrillation. METHODS Random controlled trails were gathered though searches of PubMed (1966 - 2009.11), EMBASE (1974 - 2009.11), Cochrane Library (issue 4, 2009), Chinese Biomedical Literature Database (1978 - 2009.11), China Journal Full-text Database (1994 - 2009.11), Chinese Scientific Journals Full-text Database (1989 - 2009.11). Two reviewers independently assessed eligibility and quality of trials, then extracted data. Data were synthesized using RevMan5.0 software provided by the Cochrane Collaboration. RESULTS A total of four randomized controlled trials (667 participants) were included for systematic review. Meta-analysis showed that there were statistical differences between dexamethasone and placebo in postoperative atrial fibrillation (RR = 0.6, 95%CI: 0.40 to 0.92, P = 0.02), dexamethasone did not reduce post-operative mortality (RR = 0.79, 95%CI: 0.28 to 2.22, P = 0.66). CONCLUSIONS The current evidence shows that dexamethasone could reduce the incidence of atrial fibrillation after cardiac surgery, not decrease mortality. There were few limitations in our study may lead to weaken reliability of the conclusions, such as small simple size, different operation types, or the dosage, time and frequency of dexamethasone were unclear. Its effectiveness was needed to further validate in future clinical studies.

UI MeSH Term Description Entries
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D002681 China A country spanning from central Asia to the Pacific Ocean. Inner Mongolia,Manchuria,People's Republic of China,Sinkiang,Mainland China
D003907 Dexamethasone An anti-inflammatory 9-fluoro-glucocorticoid. Hexadecadrol,Decaject,Decaject-L.A.,Decameth,Decaspray,Dexasone,Dexpak,Hexadrol,Maxidex,Methylfluorprednisolone,Millicorten,Oradexon,Decaject L.A.
D006348 Cardiac Surgical Procedures Surgery performed on the heart. Cardiac Surgical Procedure,Heart Surgical Procedure,Heart Surgical Procedures,Procedure, Cardiac Surgical,Procedure, Heart Surgical,Procedures, Cardiac Surgical,Procedures, Heart Surgical,Surgical Procedure, Cardiac,Surgical Procedure, Heart,Surgical Procedures, Cardiac,Surgical Procedures, Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001281 Atrial Fibrillation Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation. Auricular Fibrillation,Familial Atrial Fibrillation,Paroxysmal Atrial Fibrillation,Persistent Atrial Fibrillation,Atrial Fibrillation, Familial,Atrial Fibrillation, Paroxysmal,Atrial Fibrillation, Persistent,Atrial Fibrillations,Atrial Fibrillations, Familial,Atrial Fibrillations, Paroxysmal,Atrial Fibrillations, Persistent,Auricular Fibrillations,Familial Atrial Fibrillations,Fibrillation, Atrial,Fibrillation, Auricular,Fibrillation, Familial Atrial,Fibrillation, Paroxysmal Atrial,Fibrillation, Persistent Atrial,Fibrillations, Atrial,Fibrillations, Auricular,Fibrillations, Familial Atrial,Fibrillations, Paroxysmal Atrial,Fibrillations, Persistent Atrial,Paroxysmal Atrial Fibrillations,Persistent Atrial Fibrillations
D016032 Randomized Controlled Trials as Topic Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Clinical Trials, Randomized,Controlled Clinical Trials, Randomized,Trials, Randomized Clinical
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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