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Short-course of ranolazine prevents postoperative atrial fibrillation following coronary artery bypass grafting and valve surgeries

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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.

Conclusion

Adding ranolazine to standard therapy was independently associated with a significant decrease in POAF development after CABG, valve or combination surgeries.

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Acknowledgments

The authors acknowledge Drs. Harry D’Agostino and Fawad Khawaja for assistance with the study design.

Conflict of interest

None.

Author information

Author notes

  1. Drayton A. Hammond

    Present address: Department of Pharmacy Practice, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA

Authors and Affiliations

  1. Department of Pharmacy, University of Florida Health Science Center Jacksonville, 655 West 8th Street, Jacksonville, FL, 32209, USA

    Drayton A. Hammond, Christopher A. Jankowski, Stephen Tan & Marci DeLosSantos

  2. Center for Health Equity and Quality Research, 655 West 8th Street, Tower 2, 6th floor, Suite 6015, Jacksonville, FL, 32209, USA

    Carmen Smotherman & Dale Kraemer

  3. University of Florida College of Pharmacy, 653 West 8th Street, Jacksonville, FL, 32209, USA

    Christopher A. Jankowski, Stephen Tan & Marci DeLosSantos

  4. Department of Cardiothoracic Surgery, University of Florida Health Science Center Jacksonville, 655 West 8th Street, Jacksonville, FL, 32209, USA

    Omeni Osian

  5. UF Health Jacksonville, 655 West 8th Street, Jacksonville, FL, 32209, USA

    Marci DeLosSantos

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  1. Drayton A. Hammond
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Correspondence to Marci DeLosSantos.

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Hammond, D.A., Smotherman, C., Jankowski, C.A. et al. Short-course of ranolazine prevents postoperative atrial fibrillation following coronary artery bypass grafting and valve surgeries. Clin Res Cardiol 104, 410–417 (2015). https://doi.org/10.1007/s00392-014-0796-x

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  • DOI: https://doi.org/10.1007/s00392-014-0796-x

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