Efficacy of β-blockers in the prevention of postoperative atrial fibrillation after cardiac surgery: A network meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YU Langxuan ¹ , TAN Ziyi ¹ , LI Jinyan ¹ ,  WANG Xiaowen ² , LI Linjun ^1,3 , ZHANG Cheng ^1,3 , JIANG Yingjiu ²

1. The First Clinical Faculty, Chongqing Medical University, Chongqing, 400016, P. R. China;
2. Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;
3. Department of Cardiothoracic Surgery ICU, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;

Corresponding author：

WANG Xiaowen, Email: xiaowenwang@cqmu.edu.cn

Keywords：

Postoperative atrial fibrillation; β-blockers; cardiac surgery; network meta-analysis; antiarrhythmic drug

DOI：

10.7507/1007-4848.202210027

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To compare the effectiveness of different β-blockers for preventing postoperative atrial fibrillation (POAF) after cardiac surgery. Methods Databases of PubMed, Science Direct, Web of Science, The Cochrane Library, SinoMed, CKNI, VIP, WanFang were searched by the computer from inception to April 31, 2022 to collect randomized controlled studies on the comparison of the effectiveness of different β-blockers for preventing POAF. Two investigators independently screened the literature and extracted information. The quality of the literature was evaluated using Cochrane bias risk tool, and RevMan 5.3 and STATA 17.0 were used for meta-analysis. Results A total of 17 randomized controlled studies with 3 290 patients were included. Direct meta-analysis showed that landiolol and metoprolol were more effective than placebo (P≤0.001), and carvedilol was more effective than metoprolol in preventing the development of POAF (P<0.001). Network meta-analysis showed that landiolol, carvedilol and metoprolol were more effective than placebo in preventing the incidence of POAF (P<0.05). Landiolol and carvedilol were more effective than metoprolol, and carvedilol were more effective than nebivolol (P<0.05). The surface under the cumulative ranking curve from high to low were carvedilol, landilol, propranolol, atenolol, metoprolol, and nebivolol. Conclusion Carvedilol and landilol have different degrees of improvement in the occurrence of POAF, and carvedilol has the best preventive effect. More studies are required to verify the strength of evidence due to the limited sample size.

Citation： YU Langxuan, TAN Ziyi, LI Jinyan, WANG Xiaowen, LI Linjun, ZHANG Cheng, JIANG Yingjiu. Efficacy of β-blockers in the prevention of postoperative atrial fibrillation after cardiac surgery: A network meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(6): 891-899. doi: 10.7507/1007-4848.202210027 Copy

1.	Maimari M, Baikoussis NG, Gaitanakis S, et al. Does minimal invasive cardiac surgery reduce the incidence of post-operative atrial fibrillation? Ann Card Anaesth, 2020, 23(1): 7-13.
2.	Helgadottir S, Sigurdsson MI, Ingvarsdottir IL, et al. Atrial fibrillation following cardiac surgery: Risk analysis and long-term survival. J Cardiothorac Surg, 2012, 7: 87.
3.	Frendl G, Sodickson AC, Chung MK, et al. 2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures. J Thorac Cardiovasc Surg, 2014, 148(3): e153-e193.
4.	Echahidi N, Pibarot P, O'Hara G, et al. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery. J Am Coll Cardiol, 2008, 51(8): 793-801.
5.	Gillinov AM, Bagiella E, Moskowitz AJ, et al. Rate control versus rhythm control for atrial fibrillation after cardiac surgery. N Engl J Med, 2016, 374(20): 1911-1921.
6.	Healey JS, Connolly SJ, Gold MR, et al. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med, 2012, 366(2): 120-129.
7.	Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J, 2021, 42(5): 373-498.
8.	Brinkman W, Herbert MA, O'Brien S, et al. Preoperative β-blocker use in coronary artery bypass grafting surgery: National database analysis. JAMA Intern Med, 2014, 174(8): 1320-1327.
9.	POISE Study Group, Devereaux PJ, Yang H, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): A randomised controlled trial. Lancet, 2008, 371(9627): 1839-1847.
10.	Hutton B, Salanti G, Caldwell DM, et al. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: Checklist and explanations. Ann Intern Med, 2015, 162(11): 777-784.
11.	Shamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ, 2015, 350: g7647.
12.	Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: A new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev, 2019, 10: ED000142.
13.	Sterne JAC, Savović J, Page MJ, et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ, 2019, 366: l4898.
14.	Sezai A, Minami K, Nakai T, et al. Landiolol hydrochloride for prevention of atrial fibrillation after coronary artery bypass grafting: New evidence from the PASCAL trial. J Thorac Cardiovasc Surg, 2011, 141(6): 1478-1487.
15.	Sasaki K, Kumagai K, Maeda K, et al. Preventive effect of low-dose landiolol on postoperative atrial fibrillation study (PELTA study). Gen Thorac Cardiovasc Surg, 2020, 68(11): 1240-1251.
16.	Sakaguchi M, Sasaki Y, Hirai H, et al. Efficacy of landiolol hydrochloride for prevention of atrial fibrillation after heart valve surgery. Int Heart J, 2012, 53(6): 359-363.
17.	Ogawa S, Okawa Y, Goto Y, et al. Perioperative use of a beta blocker in coronary artery bypass grafting. Asian Cardiovasc Thorac Ann, 2013, 21(3): 265-269.
18.	Sezai A, Nakai T, Hata M, et al. Feasibility of landiolol and bisoprolol for prevention of atrial fibrillation after coronary artery bypass grafting: A pilot study. J Thorac Cardiovasc Surg, 2012, 144(5): 1241-1248.
19.	Paull DL, Tidwell SL, Guyton SW, et al. Beta blockade to prevent atrial dysrhythmias following coronary bypass surgery. Am J Surg, 1997, 173(5): 419-421.
20.	Lúcio Ede A, Flores A, Blacher C, et al. Effectiveness of metoprolol in preventing atrial fibrillation and flutter in the postoperative period of coronary artery bypass graft surgery. Arquivos brasileiros de cardiologia, 2004, 82(1): 42‐46.
21.	Connolly SJ, Cybulsky I, Lamy A, et al. Double-blind, placebo-controlled, randomized trial of prophylactic metoprolol for reduction of hospital length of stay after heart surgery: The beta-Blocker Length Of Stay (BLOS) study. Am Heart J, 2003, 145(2): 226-232.
22.	Auer J, Weber T, Berent R, et al. A comparison between oral antiarrhythmic drugs in the prevention of atrial fibrillation after cardiac surgery: The pilot study of prevention of postoperative atrial fibrillation (SPPAF), a randomized, placebo-controlled trial. Am Heart J, 2004, 147(4): 636-643.
23.	Erdil N, Kaynak M, Dönmez K, et al. Nebivolol in preventing atrial fibrillation following coronary surgery in patients over 60 years of age. Rev Bras Cir Cardiovasc, 2014, 29(4): 581-587.
24.	Acikel S, Bozbas H, Gultekin B, et al. Comparison of the efficacy of metoprolol and carvedilol for preventing atrial fibrillation after coronary bypass surgery. Int J Cardiol, 2008, 126(1): 108-113.
25.	Ozaydin M, Icli A, Yucel H, et al. Metoprolol vs. carvedilol or carvedilol plus N-acetyl cysteine on post-operative atrial fibrillation: A randomized, double-blind, placebo-controlled study. Eur Heart J, 2013, 34(8): 597-604.
26.	Jalalian R, Ghafari R, Ghazanfari P. Comparing the therapeutic effects of carvedilol and metoprolol on prevention of atrial fibrillation after coronary artery bypass surgery, a double-blind study. Int Cardiovasc Res J, 2014, 8(3): 111-115.
27.	Haghjoo M, Saravi M, Hashemi MJ, et al. Optimal beta-blocker for prevention of atrial fibrillation after on-pump coronary artery bypass graft surgery: Carvedilol versus metoprolol. Heart Rhythm, 2007, 4(9): 1170-1174.
28.	张佳妮, 刘英佶, 王健. 卡维地洛与美托洛尔预防冠脉搭桥术后房颤的疗效比较. 实用药物与临床, 2012, 15(6): 324-326.
29.	Stephenson LW, MacVaugh H, Tomasello DN, et al. Propranolol for prevention of postoperative cardiac arrhythmias: A randomized study. Ann Thorac Surg, 1980, 29(2): 113-116.
30.	Yazicioglu L, Eryilmaz S, Sirlak M, et al. The effect of preoperative digitalis and atenolol combination on postoperative atrial fibrillation incidence. Eur J Cardiothorac Surg, 2002, 22(3): 397-401.
31.	Yadava M, Hughey AB, Crawford TC. Postoperative atrial fibrillation: incidence, mechanisms, and clinical correlates. Heart Fail Clin, 2016, 12(2): 299-308.
32.	Yamashita K, Hu N, Ranjan R, et al. Clinical risk factors for postoperative atrial fibrillation among patients after cardiac surgery. Thorac Cardiovasc Surg, 2019, 67(2): 107-116.
33.	Baeza-Herrera LA, Rojas-Velasco G, Márquez-Murillo MF, et al. Atrial fibrillation in cardiac surgery. Arch Cardiol Mex, 2019, 89(4): 348-359.
34.	Maesen B, Nijs J, Maessen J, et al. Post-operative atrial fibrillation: A maze of mechanisms. Europace, 2012, 14(2): 159-174.
35.	Hogue CW, Hyder ML. Atrial fibrillation after cardiac operation: Risks, mechanisms, and treatment. Ann Thorac Surg, 2000, 69(1): 300-306.
36.	Zakkar M, Ascione R, James AF, et al. Inflammation, oxidative stress and postoperative atrial fibrillation in cardiac surgery. Pharmacol Ther, 2015, 154: 13-20.
37.	Gaudino M, Di Franco A, Rong LQ, et al. Pericardial effusion provoking atrial fibrillation after cardiac surgery: JACC review topic of the week. J Am Coll Cardiol, 2022, 79(25): 2529-2539.
38.	Ohtsuka T, Hamada M, Hiasa G, et al. Effect of beta-blockers on circulating levels of inflammatory and anti-inflammatory cytokines in patients with dilated cardiomyopathy. J Am Coll Cardiol, 2001, 37(2): 412-417.
39.	Workman AJ. Cardiac adrenergic control and atrial fibrillation. Naunyn Schmiedebergs Arch Pharmacol, 2010, 381(3): 235-249.
40.	Workman AJ, Kane KA, Russell JA, et al. Chronic beta-adrenoceptor blockade and human atrial cell electrophysiology: Evidence of pharmacological remodelling. Cardiovasc Res, 2003, 58(3): 518-525.
41.	Melby SJ, George JF, Picone DJ, et al. A time-related parametric risk factor analysis for postoperative atrial fibrillation after heart surgery. J Thorac Cardiovasc Surg, 2015, 149(3): 886-892.
42.	Rezaei Y, Peighambari MM, Naghshbandi S, et al. Postoperative atrial fibrillation following cardiac surgery: From pathogenesis to potential therapies. Am J Cardiovasc Drugs, 2020, 20(1): 19-49.
43.	Dobrev D, Aguilar M, Heijman J, et al. Postoperative atrial fibrillation: Mechanisms, manifestations and management. Nat Rev Cardiol, 2019, 16(7): 417-436.
44.	Nagaoka E, Arai H, Tamura K, et al. Prevention of atrial fibrillation with ultra-low dose landiolol after off-pump coronary artery bypass grafting. Ann Thorac Cardiovasc Surg, 2014, 20(2): 129-134.
45.	Osumi M, Tashiro T, Morita Y, et al. Preventive effect of intraoperative landiolol administration on atrial fibrillation after off-pump coronary artery bypass grafting. Adv Ther, 2014, 31(10): 1109-1117.
46.	Sakamoto A, Kitakaze M, Takamoto S, et al. Landiolol, an ultra-short-acting β₁-blocker, more effectively terminates atrial fibrillation than diltiazem after open heart surgery: Prospective, multicenter, randomized, open-label study (JL-KNIGHT study). Circ J, 2012, 76(5): 1097-1101.
47.	Walter E, Heringlake M. Cost-effectiveness analysis of landiolol, an ultrashort-acting beta-blocker, for prevention of postoperative atrial fibrillation for the germany health care system. J Cardiothorac Vasc Anesth, 2020, 34(4): 888-897.
48.	Ferraris A, Jacquet-Lagrèze M, Cazenave L, et al. Effects of landiolol on macrocirculatory parameters and left and right ventricular performances following cardiac surgery: A randomized controlled trial. J Cardiothorac Vasc Anesth, 2022, 36(8 Pt B): 2864-2869.
49.	Hao J, Zhou J, Xu W, et al. Beta-blocker landiolol hydrochloride in preventing atrial fibrillation following cardiothoracic surgery: A systematic review and meta-analysis. Ann Thorac Cardiovasc Surg, 2022, 28(1): 18-31.
50.	McBride BF, White CM. Critical differences among beta-adrenoreceptor antagonists in myocardial failure: Debating the MERIT of COMET. J Clin Pharmacol, 2005, 45(1): 6-24.
51.	Ji T, Feng C, Sun L, et al. Are beta-blockers effective for preventing post-coronary artery bypass grafting atrial fibrillation? Direct and network meta-analyses. Ir J Med Sci, 2016, 185(2): 503-511.
52.	Stroe AF, Gheorghiade M. Carvedilol: Beta-blockade and beyond. Rev Cardiovasc Med, 2004, 5 Suppl 1: S18-S27.
53.	Miranda SM, Mesquita ET, Dohmann HF, et al. Effects of short-term carvedilol on the cardiac sympathetic activity assessed by 123I-MIBG scintigraphy. Arq Bras Cardiol, 2010, 94(3): 308-312.
54.	Zeinah M, Elghanam M, Benedetto U. Which beta-blocker should be used for the prevention of postoperative atrial fibrillation in cardiac surgery? A multi-treatment benefit-risk meta-analysis. Egypt Heart J, 2016, 68(2): 89-96.
55.	Wakamatsu H. Effect of intra-operative low-dose infusion of landiolol hydrochloride on post-operative atrial fibrillation after off-pump coronary artery bypass grafting. Kyobu Geka, 2010, 63(9): 764-768.
56.	Sakamoto A, Hamasaki T, Kitakaze M. Perioperative landiolol administration reduces atrial fibrillation after cardiac surgery: A meta-analysis of randomized controlled trials. Adv Ther, 2014, 31(4): 440-450.
57.	Nasrollahi-Shirazi S, Sucic S, Yang Q, et al. Comparison of the β-adrenergic receptor antagonists landiolol and esmolol: Receptor selectivity, partial agonism, and pharmacochaperoning actions. J Pharmacol Exp Ther, 2016, 359(1): 73-81.
58.	Masuda Y, Luo HD, Kang GS, et al. Meta-analysis of the benefit of beta-blockers for the reduction of isolated atrial fibrillation incidence after cardiac surgery. JTCVS Open, 2020, 3: 66-85.
59.	Valtola A, Kokki H, Gergov M, et al. Does coronary artery bypass surgery affect metoprolol bioavailability. Eur J Clin Pharmacol, 2007, 63(5): 471-478.
60.	Ashes C, Judelman S, Wijeysundera DN, et al. Selective β1-antagonism with bisoprolol is associated with fewer postoperative strokes than atenolol or metoprolol: A single-center cohort study of 44, 092 consecutive patients. Anesthesiology, 2013, 119(4): 777-787.
61.	Booth JV, Ward EE, Colgan KC, et al. Metoprolol and coronary artery bypass grafting surgery: Does intraoperative metoprolol attenuate acute beta-adrenergic receptor desensitization during cardiac surgery? Anesth Analg, 2004, 98(5): 1224-1231.

1. Maimari M, Baikoussis NG, Gaitanakis S, et al. Does minimal invasive cardiac surgery reduce the incidence of post-operative atrial fibrillation? Ann Card Anaesth, 2020, 23(1): 7-13.
2. Helgadottir S, Sigurdsson MI, Ingvarsdottir IL, et al. Atrial fibrillation following cardiac surgery: Risk analysis and long-term survival. J Cardiothorac Surg, 2012, 7: 87.
3. Frendl G, Sodickson AC, Chung MK, et al. 2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures. J Thorac Cardiovasc Surg, 2014, 148(3): e153-e193.
4. Echahidi N, Pibarot P, O'Hara G, et al. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery. J Am Coll Cardiol, 2008, 51(8): 793-801.
5. Gillinov AM, Bagiella E, Moskowitz AJ, et al. Rate control versus rhythm control for atrial fibrillation after cardiac surgery. N Engl J Med, 2016, 374(20): 1911-1921.
6. Healey JS, Connolly SJ, Gold MR, et al. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med, 2012, 366(2): 120-129.
7. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J, 2021, 42(5): 373-498.
8. Brinkman W, Herbert MA, O'Brien S, et al. Preoperative β-blocker use in coronary artery bypass grafting surgery: National database analysis. JAMA Intern Med, 2014, 174(8): 1320-1327.
9. POISE Study Group, Devereaux PJ, Yang H, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): A randomised controlled trial. Lancet, 2008, 371(9627): 1839-1847.
10. Hutton B, Salanti G, Caldwell DM, et al. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: Checklist and explanations. Ann Intern Med, 2015, 162(11): 777-784.
11. Shamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ, 2015, 350: g7647.
12. Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: A new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev, 2019, 10: ED000142.
13. Sterne JAC, Savović J, Page MJ, et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ, 2019, 366: l4898.
14. Sezai A, Minami K, Nakai T, et al. Landiolol hydrochloride for prevention of atrial fibrillation after coronary artery bypass grafting: New evidence from the PASCAL trial. J Thorac Cardiovasc Surg, 2011, 141(6): 1478-1487.
15. Sasaki K, Kumagai K, Maeda K, et al. Preventive effect of low-dose landiolol on postoperative atrial fibrillation study (PELTA study). Gen Thorac Cardiovasc Surg, 2020, 68(11): 1240-1251.
16. Sakaguchi M, Sasaki Y, Hirai H, et al. Efficacy of landiolol hydrochloride for prevention of atrial fibrillation after heart valve surgery. Int Heart J, 2012, 53(6): 359-363.
17. Ogawa S, Okawa Y, Goto Y, et al. Perioperative use of a beta blocker in coronary artery bypass grafting. Asian Cardiovasc Thorac Ann, 2013, 21(3): 265-269.
18. Sezai A, Nakai T, Hata M, et al. Feasibility of landiolol and bisoprolol for prevention of atrial fibrillation after coronary artery bypass grafting: A pilot study. J Thorac Cardiovasc Surg, 2012, 144(5): 1241-1248.
19. Paull DL, Tidwell SL, Guyton SW, et al. Beta blockade to prevent atrial dysrhythmias following coronary bypass surgery. Am J Surg, 1997, 173(5): 419-421.
20. Lúcio Ede A, Flores A, Blacher C, et al. Effectiveness of metoprolol in preventing atrial fibrillation and flutter in the postoperative period of coronary artery bypass graft surgery. Arquivos brasileiros de cardiologia, 2004, 82(1): 42‐46.
21. Connolly SJ, Cybulsky I, Lamy A, et al. Double-blind, placebo-controlled, randomized trial of prophylactic metoprolol for reduction of hospital length of stay after heart surgery: The beta-Blocker Length Of Stay (BLOS) study. Am Heart J, 2003, 145(2): 226-232.
22. Auer J, Weber T, Berent R, et al. A comparison between oral antiarrhythmic drugs in the prevention of atrial fibrillation after cardiac surgery: The pilot study of prevention of postoperative atrial fibrillation (SPPAF), a randomized, placebo-controlled trial. Am Heart J, 2004, 147(4): 636-643.
23. Erdil N, Kaynak M, Dönmez K, et al. Nebivolol in preventing atrial fibrillation following coronary surgery in patients over 60 years of age. Rev Bras Cir Cardiovasc, 2014, 29(4): 581-587.
24. Acikel S, Bozbas H, Gultekin B, et al. Comparison of the efficacy of metoprolol and carvedilol for preventing atrial fibrillation after coronary bypass surgery. Int J Cardiol, 2008, 126(1): 108-113.
25. Ozaydin M, Icli A, Yucel H, et al. Metoprolol vs. carvedilol or carvedilol plus N-acetyl cysteine on post-operative atrial fibrillation: A randomized, double-blind, placebo-controlled study. Eur Heart J, 2013, 34(8): 597-604.
26. Jalalian R, Ghafari R, Ghazanfari P. Comparing the therapeutic effects of carvedilol and metoprolol on prevention of atrial fibrillation after coronary artery bypass surgery, a double-blind study. Int Cardiovasc Res J, 2014, 8(3): 111-115.
27. Haghjoo M, Saravi M, Hashemi MJ, et al. Optimal beta-blocker for prevention of atrial fibrillation after on-pump coronary artery bypass graft surgery: Carvedilol versus metoprolol. Heart Rhythm, 2007, 4(9): 1170-1174.
28. 张佳妮, 刘英佶, 王健. 卡维地洛与美托洛尔预防冠脉搭桥术后房颤的疗效比较. 实用药物与临床, 2012, 15(6): 324-326.
29. Stephenson LW, MacVaugh H, Tomasello DN, et al. Propranolol for prevention of postoperative cardiac arrhythmias: A randomized study. Ann Thorac Surg, 1980, 29(2): 113-116.
30. Yazicioglu L, Eryilmaz S, Sirlak M, et al. The effect of preoperative digitalis and atenolol combination on postoperative atrial fibrillation incidence. Eur J Cardiothorac Surg, 2002, 22(3): 397-401.
31. Yadava M, Hughey AB, Crawford TC. Postoperative atrial fibrillation: incidence, mechanisms, and clinical correlates. Heart Fail Clin, 2016, 12(2): 299-308.
32. Yamashita K, Hu N, Ranjan R, et al. Clinical risk factors for postoperative atrial fibrillation among patients after cardiac surgery. Thorac Cardiovasc Surg, 2019, 67(2): 107-116.
33. Baeza-Herrera LA, Rojas-Velasco G, Márquez-Murillo MF, et al. Atrial fibrillation in cardiac surgery. Arch Cardiol Mex, 2019, 89(4): 348-359.
34. Maesen B, Nijs J, Maessen J, et al. Post-operative atrial fibrillation: A maze of mechanisms. Europace, 2012, 14(2): 159-174.
35. Hogue CW, Hyder ML. Atrial fibrillation after cardiac operation: Risks, mechanisms, and treatment. Ann Thorac Surg, 2000, 69(1): 300-306.
36. Zakkar M, Ascione R, James AF, et al. Inflammation, oxidative stress and postoperative atrial fibrillation in cardiac surgery. Pharmacol Ther, 2015, 154: 13-20.
37. Gaudino M, Di Franco A, Rong LQ, et al. Pericardial effusion provoking atrial fibrillation after cardiac surgery: JACC review topic of the week. J Am Coll Cardiol, 2022, 79(25): 2529-2539.
38. Ohtsuka T, Hamada M, Hiasa G, et al. Effect of beta-blockers on circulating levels of inflammatory and anti-inflammatory cytokines in patients with dilated cardiomyopathy. J Am Coll Cardiol, 2001, 37(2): 412-417.
39. Workman AJ. Cardiac adrenergic control and atrial fibrillation. Naunyn Schmiedebergs Arch Pharmacol, 2010, 381(3): 235-249.
40. Workman AJ, Kane KA, Russell JA, et al. Chronic beta-adrenoceptor blockade and human atrial cell electrophysiology: Evidence of pharmacological remodelling. Cardiovasc Res, 2003, 58(3): 518-525.
41. Melby SJ, George JF, Picone DJ, et al. A time-related parametric risk factor analysis for postoperative atrial fibrillation after heart surgery. J Thorac Cardiovasc Surg, 2015, 149(3): 886-892.
42. Rezaei Y, Peighambari MM, Naghshbandi S, et al. Postoperative atrial fibrillation following cardiac surgery: From pathogenesis to potential therapies. Am J Cardiovasc Drugs, 2020, 20(1): 19-49.
43. Dobrev D, Aguilar M, Heijman J, et al. Postoperative atrial fibrillation: Mechanisms, manifestations and management. Nat Rev Cardiol, 2019, 16(7): 417-436.
44. Nagaoka E, Arai H, Tamura K, et al. Prevention of atrial fibrillation with ultra-low dose landiolol after off-pump coronary artery bypass grafting. Ann Thorac Cardiovasc Surg, 2014, 20(2): 129-134.
45. Osumi M, Tashiro T, Morita Y, et al. Preventive effect of intraoperative landiolol administration on atrial fibrillation after off-pump coronary artery bypass grafting. Adv Ther, 2014, 31(10): 1109-1117.
46. Sakamoto A, Kitakaze M, Takamoto S, et al. Landiolol, an ultra-short-acting β₁-blocker, more effectively terminates atrial fibrillation than diltiazem after open heart surgery: Prospective, multicenter, randomized, open-label study (JL-KNIGHT study). Circ J, 2012, 76(5): 1097-1101.
47. Walter E, Heringlake M. Cost-effectiveness analysis of landiolol, an ultrashort-acting beta-blocker, for prevention of postoperative atrial fibrillation for the germany health care system. J Cardiothorac Vasc Anesth, 2020, 34(4): 888-897.
48. Ferraris A, Jacquet-Lagrèze M, Cazenave L, et al. Effects of landiolol on macrocirculatory parameters and left and right ventricular performances following cardiac surgery: A randomized controlled trial. J Cardiothorac Vasc Anesth, 2022, 36(8 Pt B): 2864-2869.
49. Hao J, Zhou J, Xu W, et al. Beta-blocker landiolol hydrochloride in preventing atrial fibrillation following cardiothoracic surgery: A systematic review and meta-analysis. Ann Thorac Cardiovasc Surg, 2022, 28(1): 18-31.
50. McBride BF, White CM. Critical differences among beta-adrenoreceptor antagonists in myocardial failure: Debating the MERIT of COMET. J Clin Pharmacol, 2005, 45(1): 6-24.
51. Ji T, Feng C, Sun L, et al. Are beta-blockers effective for preventing post-coronary artery bypass grafting atrial fibrillation? Direct and network meta-analyses. Ir J Med Sci, 2016, 185(2): 503-511.
52. Stroe AF, Gheorghiade M. Carvedilol: Beta-blockade and beyond. Rev Cardiovasc Med, 2004, 5 Suppl 1: S18-S27.
53. Miranda SM, Mesquita ET, Dohmann HF, et al. Effects of short-term carvedilol on the cardiac sympathetic activity assessed by 123I-MIBG scintigraphy. Arq Bras Cardiol, 2010, 94(3): 308-312.
54. Zeinah M, Elghanam M, Benedetto U. Which beta-blocker should be used for the prevention of postoperative atrial fibrillation in cardiac surgery? A multi-treatment benefit-risk meta-analysis. Egypt Heart J, 2016, 68(2): 89-96.
55. Wakamatsu H. Effect of intra-operative low-dose infusion of landiolol hydrochloride on post-operative atrial fibrillation after off-pump coronary artery bypass grafting. Kyobu Geka, 2010, 63(9): 764-768.
56. Sakamoto A, Hamasaki T, Kitakaze M. Perioperative landiolol administration reduces atrial fibrillation after cardiac surgery: A meta-analysis of randomized controlled trials. Adv Ther, 2014, 31(4): 440-450.
57. Nasrollahi-Shirazi S, Sucic S, Yang Q, et al. Comparison of the β-adrenergic receptor antagonists landiolol and esmolol: Receptor selectivity, partial agonism, and pharmacochaperoning actions. J Pharmacol Exp Ther, 2016, 359(1): 73-81.
58. Masuda Y, Luo HD, Kang GS, et al. Meta-analysis of the benefit of beta-blockers for the reduction of isolated atrial fibrillation incidence after cardiac surgery. JTCVS Open, 2020, 3: 66-85.
59. Valtola A, Kokki H, Gergov M, et al. Does coronary artery bypass surgery affect metoprolol bioavailability. Eur J Clin Pharmacol, 2007, 63(5): 471-478.
60. Ashes C, Judelman S, Wijeysundera DN, et al. Selective β1-antagonism with bisoprolol is associated with fewer postoperative strokes than atenolol or metoprolol: A single-center cohort study of 44, 092 consecutive patients. Anesthesiology, 2013, 119(4): 777-787.
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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy of β-blockers in the prevention of postoperative atrial fibrillation after cardiac surgery: A network meta-analysis

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