[Effect of dexamethasone on atrial fibrillation after cardiac surgery: a meta-analysis].
OBJECTIVE
To assess the effect of preoperative dexamethasone on the occurrence of postoperative atrial fibrillation.


METHODS
Random controlled trails were gathered though searches of PubMed (1966 - 2009.11), EMBASE (1974 - 2009.11), Cochrane Library (issue 4, 2009), Chinese Biomedical Literature Database (1978 - 2009.11), China Journal Full-text Database (1994 - 2009.11), Chinese Scientific Journals Full-text Database (1989 - 2009.11). Two reviewers independently assessed eligibility and quality of trials, then extracted data. Data were synthesized using RevMan5.0 software provided by the Cochrane Collaboration.


RESULTS
A total of four randomized controlled trials (667 participants) were included for systematic review. Meta-analysis showed that there were statistical differences between dexamethasone and placebo in postoperative atrial fibrillation (RR = 0.6, 95%CI: 0.40 to 0.92, P = 0.02), dexamethasone did not reduce post-operative mortality (RR = 0.79, 95%CI: 0.28 to 2.22, P = 0.66).


CONCLUSIONS
The current evidence shows that dexamethasone could reduce the incidence of atrial fibrillation after cardiac surgery, not decrease mortality. There were few limitations in our study may lead to weaken reliability of the conclusions, such as small simple size, different operation types, or the dosage, time and frequency of dexamethasone were unclear. Its effectiveness was needed to further validate in future clinical studies.
The Evidence-based Medicine Center of Lanzhou University, Lanzhou 730000, China.
Kang
K
Yi
Jin-Hui
JH
Tian
Bin
B
Zhang
Bing
B
Song
Ke-Hu
KH
Yang
D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures; D002681:China; D003907:Dexamethasone / Q000627:therapeutic use*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D003907:Dexamethasone