title: Are beta-blockers effective for preventing post-coronary artery bypass grafting atrial fibrillation? Direct and network meta-analyses.
abstract: BACKGROUND
  Atrial fibrillation is the most common arrhythmia in clinical practice and is a major contributor to mortality. Recently, several studies have reported different results for treatments aimed at reducing the risk of postoperative AF.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the efficacy of beta-blockers (BBs) in preventing post-coronary artery bypass grafting (CABG) AF and to compare the efficacies of different BB treatments using a network meta-analytical approach.
  
  
  METHODS
  The PubMed, EMBASE and Cochrane Library databases were searched (Jan 1995 to May 2014) to identify randomized controlled trials. Two independent investigators separately extracted the data using a seven-point scoring system to assess randomization, allocation concealment, blinding, withdrawals and dropouts. A direct meta-analysis of these randomized controlled trials was conducted. Then, six trials comparing different BB treatments for the prevention of postoperative AF were added to perform a Bayesian network meta-analysis with mixed treatment comparisons.
  
  
  RESULTS
  Treatment with BBs was associated with a significant reduction in the postoperative incidence of AF compared with placebo/control [22.37 % compared with 34.45 %, relative risk (RR) = 0.53, 95 % confidence interval (CI): 0.37-0.75, p < 0.00001].
  
  
  CONCLUSIONS
  The network meta-analysis revealed no significant differences among eight types of BB treatments but did provide a ranking. BB treatments could significantly reduce the occurrence of post-CABG AF. Insufficient evidence was available to show that one BB treatment was more effective than the others were. According to our network meta-analysis, bisoprolol and landiolol+bisoprolol are better alternatives compared with the other treatments.
authors.affiliation: Department of Geriatrics, Shanghai First People's Hospital Affiliated with Shanghai Jiaotong University, Shanghai, China.
authors.forename: T
authors.initials: T
authors.lastname: Ji
authors.affiliation: Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: C
authors.initials: C
authors.lastname: Feng
authors.affiliation: Department of Nephrology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: L
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Health Statistics, Second Military Medical University, Shanghai, China.
authors.forename: X
authors.initials: X
authors.lastname: Ye
authors.affiliation: Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Qin
authors.affiliation: Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China. zjq77324@126.com.
authors.forename: J
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China. 13601713431@163.com.
authors.forename: X
authors.initials: X
authors.lastname: Zhao
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000517:prevention & control*; D001499:Bayes Theorem; D017298:Bisoprolol / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000379:methods*; D006801:Humans; D015994:Incidence; D009025:Morpholines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D014508:Urea / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D009025:Morpholines; C077049:landiolol; D014508:Urea; D017298:Bisoprolol
keywords: Atrial fibrillation; Beta-blockers; CABG; Network meta-analysis