Short-course of ranolazine prevents postoperative atrial fibrillation following coronary artery bypass grafting and valve surgeries

Drayton A. Hammond, Carmen Smotherman, Christopher A. Jankowski, Stephen Tan, Omeni Osian, Dale Kraemer, Marci DeLosSantos

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Postoperative atrial fibrillation (POAF) is a common complication arising after coronary artery bypass grafting (CABG) and valve replacement or repair surgeries. POAF has been associated with increased mortality, morbidity and cost.

Methods: The study was conducted to evaluate the incidence of POAF following CABG, valve or combination surgeries when perioperative ranolazine (1,000 mg preoperatively, then 1,000 mg twice daily for 7 days or until discharge) was or was not added to standard therapy.

Results: A total of 205 patients were evaluated for POAF after CABG, valve or combination surgeries. POAF occurred less frequently in the ranolazine group compared with the non-ranolazine group in unmatched analysis (10.1 vs. 41.9 %, p < 0.0001). After adjusting for potential sources of bias through propensity-score matched-pair analysis and conditional logistic regression, ranolazine was an independent predictor of preventing POAF (p < 0.0001). There were no differences in bradycardia, new renal failure or neurological events between the two groups. Early, symptomatic hypotension occurred more frequently in the ranolazine group (p = 0.0004) although this difference did not persist after 72 h. No significant difference was found in the length of stay in the intensive care unit following cardiac surgery. While a significant difference was found in the hospital readmission rate for a cardiac cause within 30 days in the unmatched analysis (p = 0.046), this difference was nonexistent after matching (p = 0.39). No difference was found in 30-day cardiovascular mortality.

Conclusion: Adding ranolazine to standard therapy was independently associated with a significant decrease in POAF development after CABG, valve or combination surgeries.

Original languageEnglish (US)
Pages (from-to)410-417
Number of pages8
JournalClinical Research in Cardiology
Volume104
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

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Coronary Artery Bypass
Atrial Fibrillation
Matched-Pair Analysis
Patient Readmission
Propensity Score
Mortality
Bradycardia
Ranolazine
Hypotension
Thoracic Surgery
Renal Insufficiency
Intensive Care Units
Length of Stay
Logistic Models
Morbidity
Costs and Cost Analysis
Incidence
Therapeutics

Keywords

  • Coronary artery bypass grafting
  • Heart valve surgery
  • Postoperative atrial fibrillation
  • Ranolazine

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Short-course of ranolazine prevents postoperative atrial fibrillation following coronary artery bypass grafting and valve surgeries. / Hammond, Drayton A.; Smotherman, Carmen; Jankowski, Christopher A.; Tan, Stephen; Osian, Omeni; Kraemer, Dale; DeLosSantos, Marci.

In: Clinical Research in Cardiology, Vol. 104, No. 5, 01.05.2015, p. 410-417.

Research output: Contribution to journalArticle

Hammond, Drayton A. ; Smotherman, Carmen ; Jankowski, Christopher A. ; Tan, Stephen ; Osian, Omeni ; Kraemer, Dale ; DeLosSantos, Marci. / Short-course of ranolazine prevents postoperative atrial fibrillation following coronary artery bypass grafting and valve surgeries. In: Clinical Research in Cardiology. 2015 ; Vol. 104, No. 5. pp. 410-417.
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AU - Hammond, Drayton A.

AU - Smotherman, Carmen

AU - Jankowski, Christopher A.

AU - Tan, Stephen

AU - Osian, Omeni

AU - Kraemer, Dale

AU - DeLosSantos, Marci

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KW - Coronary artery bypass grafting

KW - Heart valve surgery

KW - Postoperative atrial fibrillation

KW - Ranolazine

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