title: N-acetylcysteine for the prevention of postoperative atrial fibrillation: a prospective, randomized, placebo-controlled pilot study.
abstract: OBJECTIVE
  Oxidative stress has recently been implicated in the pathophysiology of atrial fibrillation (AF). The aim of the present study was to evaluate the effects of antioxidant agent N-acetylcysteine (NAC) on postoperative AF.
  
  
  RESULTS
  The population of this prospective, randomized, double-blind, placebo-controlled study consisted of 115 patients undergoing coronary artery bypass and/or valve surgery. All the patients were treated with standard medical therapy and were randomized to NAC group (n = 58) or placebo (saline, n = 57). An AF episode >5 min during hospitalization was accepted as endpoint. During follow-up period, 15 patients (15/115, 13%) had AF. The rate of AF was lower in NAC group compared with placebo group (three patients in NAC group [5.2%] and 12 patients in placebo group [21.1%] had postoperative AF; odds ratio [OR] 0.20; 95% confidence interval [CI] 0.05 to 0.77; P = 0.019). In the multivariable logistic regression analysis, independent predictors of postoperative AF were left atrial diameter (OR, 1.18; 95% CI, 1.06-1.31; P = 0.002) and the use of NAC (OR, 0.20; 95% CI, 0.04-0.91; P = 0.038).
  
  
  CONCLUSIONS
  The result of this study indicates that NAC treatment decreases the incidence of postoperative AF.
authors.affiliation: Department of Cardiology, Suleyman Demirel University, School of Medicine, 32040 Isparta, Turkey. mehmetozaydin@hotmail.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozaydin
authors.forename: Oktay
authors.initials: O
authors.lastname: Peker
authors.forename: Dogan
authors.initials: D
authors.lastname: Erdogan
authors.forename: Sahin
authors.initials: S
authors.lastname: Kapan
authors.forename: Yasin
authors.initials: Y
authors.lastname: Turker
authors.forename: Ercan
authors.initials: E
authors.lastname: Varol
authors.forename: Fehmi
authors.initials: F
authors.lastname: Ozguner
authors.forename: Abdullah
authors.initials: A
authors.lastname: Dogan
authors.forename: Erdogan
authors.initials: E
authors.lastname: Ibrisim
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*
chemical_list: D000889:Anti-Arrhythmia Agents; D000111:Acetylcysteine