title: A Double-Blind Placebo-Controlled Study of the Effects of Olprinone, a Specific Phosphodiesterase III Inhibitor, for Preventing Postoperative Atrial Fibrillation in Patients Undergoing Pulmonary Resection for Lung Cancer.
abstract: BACKGROUND
  We previously reported that patients with elevated preoperative B-type natriuretic peptide (BNP) levels have an increased risk for postoperative atrial fibrillation following lung cancer surgery. The present study evaluated whether the specific phosphodiesterase III inhibitor olprinone can reduce the incidence of postoperative atrial fibrillation in patients with elevated BNP levels undergoing pulmonary resection for lung cancer.
  
  
  METHODS
  A prospective randomized study was conducted with 40 patients who had elevated preoperative BNP levels (≥ 30 pg/mL) and underwent scheduled lung cancer surgery. All patients were in sinus rhythm at surgery. Low-dose olprinone or placebo was continuously infused for 24 h and started just before anesthesia induction. The primary end point was the incidence of postoperative atrial fibrillation. The secondary end points were perioperative hemodynamics and levels of BNP, WBC counts, and C-reactive protein.
  
  
  RESULTS
  The incidence of postoperative atrial fibrillation was significantly lower in the olprinone group than in the placebo group (10% vs 60%, P < .001). Patients in the olprinone group showed significantly lower BNP, WBC counts, and C-reactive protein levels after surgery.
  
  
  CONCLUSIONS
  Continuous infusion of olprinone during lung cancer surgery was safe and reduced the incidence of postoperative atrial fibrillation following pulmonary resection in patients with elevated preoperative BNP levels.
  
  
  BACKGROUND
  Japan Primary Registries Network; No.: JPRN-UMIN2404; URL: http://www.umin.ac.jp/ctr/.
authors.affiliation: Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Osaka; Department of Biochemistry, Research Institute, National Cerebral and Cardiovascular Center, Osaka; Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka. Electronic address: nojirit@thoracic.med.osaka-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nojiri
authors.affiliation: Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Tottori, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Osaka.
authors.forename: Hajime
authors.initials: H
authors.lastname: Maeda
authors.affiliation: Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Osaka.
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Takeuchi
authors.affiliation: Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Osaka.
authors.forename: Naoko
authors.initials: N
authors.lastname: Ose
authors.affiliation: Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Osaka.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Susaki
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka.
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D058987:Phosphodiesterase 3 Inhibitors / Q000008:administration & dosage; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D011446:Prospective Studies; D011728:Pyridones / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D007093:Imidazoles; D058987:Phosphodiesterase 3 Inhibitors; D011728:Pyridones; C059498:olprinone