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American Journal of Cardiovascular Drugs

, Volume 11, Issue 4, pp 277–284 | Cite as

Role of Irbesartan in Prevention of Post-Coronary Artery Bypass Graft Atrial Fibrillation

  • Mohamed A. El-Haddad
  • Sandip K. Zalawadiya
  • Hany Awdallah
  • Sameh Sabet
  • Haitham A. El-Haddad
  • Ashraf Mostafa
  • Ahmed Rashed
  • Wael El-Naggar
  • Nabil Farag
  • Mohamed A. Saleb
  • Sony Jacob
Original Research Article

Abstract

Background and Objective

Atrial fibrillation (AF) is a common complication of cardiothoracic surgery (CTS). Existing evidence about the potential protective role of angiotensin II type 1 receptor antagonists (angiotensin receptor blockers [ARBs]) for post-CTS AF has been limited and conflicting. In this single-blind, open-label, randomized prospective pilot study, we evaluated the potential protective role of irbesartan (an ARB) in post-coronary artery bypass graft (CABG) AF.

Methods

A total of 100 consecutive patients undergoing CABG were randomly assigned to irbesartan (n = 50) versus no irbesartan (n = 50) for 5 days prior to the scheduled surgery. Data were collected for imaging studies, laboratory values, and peri-operative details. Patients were monitored post-operatively for in-hospital AF episodes. Unadjusted and adjusted logistic regression analysis was performed to assess the effect of irbesartan on the incidence of post-CABG AF.

Results

A total of 14 patients developed AF during their post-operative hospital stay. The incidence of AF in patients who received irbesartan was 6% (n = 3) compared with 22% (n = 11) in patients who did not receive irbesartan (p = 0.021). Univariate logistic regression analysis identified irbesartan and age as statistically significant variables. An adjusted multivariate logistic model identified irbesartan as an important protective factor against development of post-CABG AF (adjusted odds ratio [OR] 0.20; 95% confidence interval [CI] 0.04, 0.94; p = 0.04). Increasing age (adjusted OR 1.09, 95% CI 1.01, 1.17; p = 0.03) was also identified as an independent risk factor for development of post-CABG AF.

Conclusion

Pretreatment with irbesartan tends to have a significant protective effect against the occurrence of AF during the post-operative period in patients undergoing CABG.

Keywords

Atrial Fibrillation Left Ventricular Ejection Fraction Coronary Artery Bypass Graft Irbesartan Thoracic Aortic Aneurysm 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

No funding sources were used to conduct this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Copyright information

© Adis Data Information BV 2011

Authors and Affiliations

  • Mohamed A. El-Haddad
    • 1
  • Sandip K. Zalawadiya
    • 3
  • Hany Awdallah
    • 1
  • Sameh Sabet
    • 1
  • Haitham A. El-Haddad
    • 4
  • Ashraf Mostafa
    • 3
  • Ahmed Rashed
    • 4
  • Wael El-Naggar
    • 4
  • Nabil Farag
    • 1
  • Mohamed A. Saleb
    • 1
  • Sony Jacob
    • 2
    • 3
  1. 1.Dar Al-Fouad Hospital, Giza, Egypt and Faculty of MedicineAin Shams UniversityCairoEgypt
  2. 2.Division of Cardiology/ElectrophysiologyWayne State University/Detroit Medical CenterDetroitUSA
  3. 3.Department of Internal MedicineWayne State University/Detroit Medical CenterDetroitUSA
  4. 4.Cairo University School of MedicineGizaEgypt

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