title: Perioperative ascorbic acid supplementation does not reduce the incidence of postoperative atrial fibrillation in on-pump coronary artery bypass graft patients.
abstract: Atrial fibrillation is the most common arrhythmia following cardiac surgery. It is associated with increased hemodynamic instability, systemic embolization, and complications linked to anticoagulant therapy. Oxidative stress and consequent electrophysiological remodeling have been proposed as a cause of postoperative atrial fibrillation. Ascorbic acid supplementation was suggested as a novel and effective preventive agent. The aim of this study was to evaluate the capability of ascorbic acid to reduce the incidence of postoperative atrial fibrillation in coronary artery bypass grafting (CABG) patients.
  
  
  
  A prospective randomized single-center trial was conducted in patients scheduled for an elective on-pump CABG surgery. Subjects in the ascorbic acid group received 2g of ascorbic acid 24h and 2h before the surgery and 1g twice a day for five days after the surgery. Postoperatively, the patients were monitored for atrial fibrillation and other complications.
  
  
  
  The ascorbic acid group consisted of 52 patients and the control group included 53 patients. The groups were well matched for baseline demographics, preoperative medications, comorbidities, and had similar intraoperative characteristics. The incidence of atrial fibrillation in the ascorbic acid group was 13.5% and 18.9% in the control group (p=0.314). No difference was found between groups in the time of occurrence of atrial fibrillation (3.71±1.89 vs. 2.91±1.58 days after the surgery; p=0.342). There was also no difference in the other observed postoperative complications.
  
  
  
  The results of this study do not support the effectiveness of ascorbic acid supplementation in reducing the incidence of postoperative atrial fibrillation in elective on-pump CABG patients.
authors.affiliation: Department for Cardiac Surgery, University Medical Center Maribor, Maribor, Slovenia. Electronic address: miha.antonic@guest.arnes.si.
authors.forename: Miha
authors.initials: M
authors.lastname: Antonic
authors.affiliation: Department for Cardiac Surgery, University Medical Center Maribor, Maribor, Slovenia.
authors.forename: Robert
authors.initials: R
authors.lastname: Lipovec
authors.affiliation: Department for Cardiac Surgery, University Medical Center Maribor, Maribor, Slovenia.
authors.forename: Franc
authors.initials: F
authors.lastname: Gregorcic
authors.affiliation: Department for Cardiac Surgery, University Medical Center Maribor, Maribor, Slovenia.
authors.forename: Peter
authors.initials: P
authors.lastname: Juric
authors.affiliation: Department for Cardiac Surgery, University Medical Center Maribor, Maribor, Slovenia.
authors.forename: Gorazd
authors.initials: G
authors.lastname: Kosir
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000517:prevention & control*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies
chemical_list: D000975:Antioxidants; D001205:Ascorbic Acid
keywords: Ascorbic acid; Atrial fibrillation; Coronary artery bypass grafting; Vitamin C