title: Perioperative use of a beta blocker in coronary artery bypass grafting.
abstract: OBJECTIVE
  Atrial fibrillation after cardiac surgery is associated with increases in the risk of complications, length of intensive care unit stay, and cost of care. Beta blockers are effective for controlling myocardial ischemia and arrhythmia and suppressing inflammatory cytokines. The purpose of this study was to examine the effect of administrating a short-acting beta-adrenoceptor antagonist, landiolol, on postoperative atrial fibrillation.
  
  
  METHODS
  136 patients undergoing off-pump coronary artery bypass grafting were single-blindly assigned randomly to landiolol (n = 68) and non-landiolol (control, n = 68) groups. In the landiolol group, the beta blocker was administered from the beginning of the operation until postoperative day 2. The primary endpoint was the incidence of atrial fibrillation until postoperative day 7, and the secondary endpoints were the postoperative levels of troponin I, creatine kinase MB-isoenzyme, and C-reactive protein.
  
  
  RESULTS
  The incidence of atrial fibrillation was significantly lower in the landiolol group compared to the control group (13/68, 19% vs. 25/68, 37%, p = 0.02, logrank test). Landiolol also significantly reduced the postoperative peak C-reactive protein level compared to the control group (132 ± 55.4 vs. 161 ± 50.9 mgċL(-1), p = 0.004).
  
  
  CONCLUSIONS
  Low-dose continuous infusion of landiolol reduced the incidence of postoperative atrial fibrillation, and significantly suppressed inflammation.
authors.affiliation: Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ogawa
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Okawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Goto
authors.forename: Masakazu
authors.initials: M
authors.lastname: Aoki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Baba
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D052279:Creatine Kinase, MB Form / Q000097:blood; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control; D007263:Infusions, Parenteral; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D009025:Morpholines; D019210:Troponin I; C077049:landiolol; D014508:Urea; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form
keywords: Landiolol [supplementary concept]; adrenergic beta-antagonists; atrial fibrillation; coronary artery bypass; perioperative care