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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. AIMS: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.

journal_name

Ir J Med Sci

journal_title

Irish journal of medical science

authors

Ji T,Feng C,Sun L,Ye X,Bai Y,Chen Q,Qin Y,Zhu J,Zhao X

doi

10.1007/s11845-016-1447-1

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

503-11

issue

eissn

0021-1265

issn

1863-4362

pii

10.1007/s11845-016-1447-1

journal_volume

185

pub_type

杂志文章,meta分析

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Are beta-blockers effective for preventing post-coronary artery bypass grafting atrial fibrillation? Direct and network meta-analyses.