Prevention of Atrial Fibrillation in High-risk Patients Undergoing Lung Cancer Surgery: The PRESAGE Trial

Annals of Surgery
Daniela CardinaleCarlo Maria Cipolla

Abstract

We performed a prospective, randomized clinical study to assess whether prophylactic treatment with metoprolol or losartan, initiated soon after lung cancer surgery in patients with elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, reduces the incidence of postoperative atrial fibrillation. Postoperative atrial fibrillation is a well recognized complication after lung cancer surgery, with an incidence as high as 30%. Perioperative increase of NT-proBNP has been demonstrated to be a strong independent predictor of postoperative atrial fibrillation in this setting. NT-proBNP concentration was measured 24 hours before surgery and soon after surgery in 1116 patients. Three hundred twenty (29%) patients showed a high NT-proBNP value and were enrolled: 108 were assigned to the metoprolol group, 102 to the losartan group, and 110 to the control group. Overall, the incidence of postoperative atrial fibrillation was 20% (n = 64); it was significantly lower in the metoprolol and losartan groups compared with the control group [6%, 12%, and 40%, respectively; relative risk 0.19, 95% confidence intervals (CIs), 0.09-0.37; P < 0.001 in the metoprolol group; and 0.29, 95% CI, 0.16-0.52; P < 0.001 in the losartan group). N...Continue Reading

References

Nov 5, 1997·Journal of Cardiothoracic and Vascular Anesthesia·C J JakobsenE B Andresen
May 1, 1998·International Journal of Epidemiology·T SkovL Endahl
Mar 23, 1999·The Annals of Thoracic Surgery·C D BayliffR S Kennedy
Sep 26, 2000·The Journal of Thoracic and Cardiovascular Surgery·D AmarR J Ginsberg
Apr 27, 2002·Heart Disease·David Amar
May 22, 2002·Journal of the American College of Cardiology·Wendy JohnsonLynne W Stevenson
Jun 25, 2002·The American Journal of Medicine·Michihiro YoshimuraHisao Ogawa
Jun 25, 2005·European Heart Journal·Mads D M Engelmann, Jesper Hastrup Svendsen
Jan 28, 2006·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Keiichi IshidaMasaru Miyazaki
Apr 8, 2006·Clinical Chemistry and Laboratory Medicine : CCLM·Aldo ClericoMichele Emdin
Oct 31, 2006·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Joel DunningUNKNOWN EACTS Audit and Guidelines Committee
Jan 30, 2007·The Annals of Thoracic Surgery·Niyazi GulerHasan Ali Gumrukcuoglu
Aug 3, 2007·Interactive Cardiovascular and Thoracic Surgery·Vivek ShrivastavaGraham Morritt
Aug 19, 2007·International Journal of Cardiology·Mehmet OzaydinErdogan Ibrisim
Aug 25, 2009·The Annals of Thoracic Surgery·James E TisdaleKenneth A Kesler
Nov 10, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Takashi NojiriMeinoshin Okumura
Dec 17, 2010·Journal of Cardiovascular Pharmacology and Therapeutics·Kurt ReinhartMelanie Ley-Wah Siv
Jan 1, 2010·Seminars in Thoracic and Cardiovascular Surgery·James E TisdaleKenneth A Kesler
Jan 21, 2012·The Korean Journal of Thoracic and Cardiovascular Surgery·Chang Young LeeKyung Young Chung
Feb 22, 2012·ISRN Cardiology·C ChelazziA R De Gaudio
Jul 31, 2012·The Journal of Thoracic and Cardiovascular Surgery·David AmarValerie W Rusch
Oct 22, 2013·JAMA : the Journal of the American Medical Association·UNKNOWN World Medical Association
Aug 15, 2014·JAMA : the Journal of the American Medical Association·Gino GialdiniHooman Kamel
Oct 7, 2014·The Annals of Thoracic Surgery·Lars Peter RiberThomas Decker Christensen

❮ Previous
Next ❯

Citations

May 22, 2018·Current Medical Research and Opinion·Guido Grassi
Sep 27, 2019·The Cochrane Database of Systematic Reviews·Hermann BlessbergerClemens Steinwender
May 1, 2020·European Heart Journal. Cardiovascular Pharmacotherapy·Joachim AlexandreCharles Dolladille
Sep 7, 2018·European Heart Journal Supplements : Journal of the European Society of Cardiology·Martin BalikGottfried Heinz
Dec 28, 2019·Journal of Clinical Medicine·Iacopo FabianiDaniela Maria Cardinale
Aug 28, 2021·Cancers·Gennaro Carmine SemeraroDaniela Maria Cardinale
Dec 20, 2017·The Journal of Thoracic and Cardiovascular Surgery·Abraham D GellerMichael Lanuti

❮ Previous
Next ❯

Methods Mentioned

BETA
coronary artery bypass

Clinical Trials Mentioned

NCT01281787

Software Mentioned

SAS

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.