Omega-3 Polyunsaturated Fatty Acids Reduce the Incidence of Postoperative Atrial Fibrillation in Patients with History of Prior Myocardial Infarction Undergoing Isolated Coronary Artery Bypass Grafting
28. November 2013
13. Januar 2014
22. April 2014 (online)
Introduction The impact of omega-3 polyunsaturated fatty acids (PUFAs) for prevention of atrial fibrillation (AF) is still part of a lively debate. The present study evaluates the impact of orally administered omega-3 ethyl ester concentrate (omega-3 PUFA) on postoperative onset of AF in patients with recent myocardial infarction (≤ 3 months) undergoing isolated coronary artery bypass grafting (CABG).
Patients and Methods The study included a total of 198 patients with recent (≤ 3 months) myocardial infarction. The treatment group consisted of 99 prospectively and randomly assigned patients. A matched control group was generated out of the entirety of patients undergoing isolated CABG during the same time period, being not treated with omega-3 PUFA. Primary endpoint was onset of postoperative AF. Patients of the treatment group received a daily dose of 2 g omega-3 PUFA, initiated 5 days before surgery. Effective serum levels were confirmed by laboratory testing.
Results Patients of the treatment group had less frequently postoperative AF (treatment: 31.3% vs. control: 48.0%; p = 0.017). The reduction in relative risk was 34.8% in the treatment group, which conforms a number needed to treat (NNT) of 6.0 patients. A more pronounced effect with a NNT of 4.1 was observed in patients ≤ 70 years (p = 0.007). Besides, patients of the treatment group had a shorter intensive care unit stay (p = 0.001) and suffered less frequently from impaired wound healing by trend (p = 0.063). One patient out of treatment group and two out of control group died during hospital stay (p = 1.000).
Conclusion Preoperative administration of 2 g omega-3 PUFA reduces incidence of postoperative AF in patients with recent (≤ 3 months) myocardial infarction undergoing isolated CABG.
These data were presented at the 43rd Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery, 9th to 12th February 2014 in Freiburg.
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