N-acetylcysteine does not decrease AF incidence after CABG
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N-acetylcysteine, an antioxidant supplement, administered with carvedilol did not prevent postoperative atrial fibrillation in patients who underwent CABG compared with carvedilol alone, data from a single-center study show.
“The use of cardiopulmonary bypass during cardiothoracic surgery and the systemic exposure to these nonbiologic surfaces has been shown to provoke an oxidative stress response,” Mohammadreza Iranian, MD, of the Rajaie Cardiovascular Medical and Research Center at Iran University of Medical Science in Tehran, and colleagues wrote in the study background. “Thus, agents with antioxidant properties may attenuate the oxidative stress and resultant inflammation in patients undergoing cardiothoracic surgery and potentially reduce postoperative complications like postoperative AF.”
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Iranian and colleagues analyzed data from 300 adults who underwent CABG in 2016 and 2017 and did not have a contraindication for beta‐blockers. Researchers randomly assigned participants to N-acetylcysteine plus carvedilol (n = 150) or carvedilol (n = 150). Researchers monitored participants for 5 days after surgery and the incidence of AF during hospitalization was recorded.
The findings were published in the Journal of Cardiac Surgery.
Researchers observed AF in 9.3% of patients in the N-acetylcysteine with carvedilol group and in 15.3% of patients in the carvedilol-alone group. There were no between-group differences in postoperative AF (P = .112); however, in multivariable regression analysis, researchers noted the incidence of postoperative AF was numerically lower in the N-acetylcysteine plus carvedilol group (P = .1).
“Results of our study showed that N-acetylcysteine cannot have a significant effect on decreasing the incidence of AF following CABG surgery,” the researchers wrote. “However, it should be noted that considering the P value is close to .05, by changing the number of studied samples or using a higher dose of N-acetylcysteine or using intravenous injection, a significant relationship between the N-acetylcysteine administration and decrease in the incidence of AF following CABG may be observed.”
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