N-3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial.
OBJECTIVE
The aim of this study was to assess the efficacy of preoperative and postoperative treatment with n-3 polyunsaturated fatty acids (PUFAs) in preventing the occurrence of atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG).


BACKGROUND
Postoperative AF is a common complication of CABG. There is growing clinical evidence that PUFAs have cardiac antiarrhythmic effects.


METHODS
A total of 160 patients were prospectively randomized to a control group (81 patients, 13 female, 64.9 +/- 9.1 years) or PUFAs 2 g/day (79 patients, 11 female, 66.2 +/- 8.0 years) for at least 5 days before elective CABG and until the day of discharge from the hospital. The primary end point was the development of AF in the postoperative period. The secondary end point was the hospital length of stay after surgery. All end points were independently adjudicated by two cardiologists blinded to treatment assignment.


RESULTS
The clinical and surgical characteristics of the patients in the two groups were similar. Postoperative AF developed in 27 patients of the control group (33.3%) and in 12 patients of the PUFA group (15.2%) (p = 0.013). There was no significant difference in the incidence of nonfatal postoperative complications, and postoperative mortality was similar in the PUFA-treated patients (1.3%) versus controls (2.5%). After CABG, the PUFA patients were hospitalized for significantly fewer days than controls (7.3 +/- 2.1 days vs. 8.2 +/- 2.6 days, p = 0.017).


CONCLUSIONS
This study first demonstrates that PUFA administration during hospitalization in patients undergoing CABG substantially reduced the incidence of postoperative AF (54.4%) and was associated with a shorter hospital stay.
Calò
Leonardo
L
Department of Cardiac Diseases, San Filippo Neri Hospital, Rome, Italy. leonardo.calo@tin.it
Bianconi
Leopoldo
L
Colivicchi
Furio
F
Lamberti
Filippo
F
Loricchio
Maria Luisa
ML
de Ruvo
Ermenegildo
E
Meo
Antonella
A
Pandozi
Claudio
C
Staibano
Mario
M
Santini
Massimo
M
D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality / Q000517:prevention & control*; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D004562:Electrocardiography / Q000187:drug effects; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control*; D011292:Premedication; D015996:Survival Rate; D016896:Treatment Outcome
D015525:Fatty Acids, Omega-3