title: Short-course of ranolazine prevents postoperative atrial fibrillation following coronary artery bypass grafting and valve surgeries.
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.
  
  
  CONCLUSIONS
  Adding ranolazine to standard therapy was independently associated with a significant decrease in POAF development after CABG, valve or combination surgeries.
authors.affiliation: Department of Pharmacy, University of Florida Health Science Center Jacksonville, 655 West 8th Street, Jacksonville, FL, 32209, USA.
authors.forename: Drayton A
authors.initials: DA
authors.lastname: Hammond
authors.forename: Carmen
authors.initials: C
authors.lastname: Smotherman
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Jankowski
authors.forename: Stephen
authors.initials: S
authors.lastname: Tan
authors.forename: Omeni
authors.initials: O
authors.lastname: Osian
authors.forename: Dale
authors.initials: D
authors.lastname: Kraemer
authors.forename: Marci
authors.initials: M
authors.lastname: DeLosSantos
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D058385:Cardiac Valve Annuloplasty / Q000009:adverse effects*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005858:Germany / Q000453:epidemiology; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D000069458:Ranolazine / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D002317:Cardiovascular Agents; D000069458:Ranolazine