%0 Journal Article
%T N-acetylcysteine supplementation for the prevention of atrial fibrillation after cardiac surgery: a meta-analysis of eight randomized controlled trials
%A Wan-Jie Gu
%A Zhen-Jie Wu
%A Peng-Fei Wang
%A Lynn Htet Aung
%A Rui-Xing Yin
%J BMC Cardiovascular Disorders
%D 2012
%I BioMed Central
%R 10.1186/1471-2261-12-10
%X Medline and Embase were systematically reviewed for studies published up to November 2011, in which NAC was compared with controls for adult patients undergoing cardiac surgery. Outcome measures comprised the incidence of POAF and hospital length of stay (LOS). The meta-analysis was performed with the fixed-effect model or random-effect model according to the heterogeneity.Eight randomized trials incorporating 578 patients provided the best evidence and were included in this meta-analysis. NAC supplementation significantly reduced the incidence of POAF (OR 0.62, 95% CI 0.41 to 0.93; P = 0.021) compared with controls, but had no effect on LOS (WMD -0.07, 95% CI -0.42 to 0.28; P = 0.703).The prophylactic NAC supplementation may effectively reduce the incidence of POAF. However, the overall quality of current studies is poor and further research should focus on adequately powered randomized controlled trials with POAF incidence as a primary outcome measure.Postoperative atrial fibrillation (POAF) is the most frequent arrhythmia encountered following cardiac surgery, affecting approximately 25-40% of patients [1-3]. Although the majority of POAF are benign and self-limiting, it has been associated with an increase in both hospital length of stay (LOS) and total hospital costs [1,2,4,5]. The efficacy of pharmacologic interventions on preventing POAF has been extensively researched [6,7]. Recent guidelines for the prevention and management of POAF were published in 2011 jointly by the American College of Cardiology, the AHA, and the European Society of Cardiology [8]. Nevertheless, none of them are effective for all patients and all of them have significant limitations, the best prophylaxis to prevent POAF remains to be established [9]. Despite the extensive studies, the pathphysiology of POAF are for the moment far from being fully elucidated. In the past few years, a growing body of evidence suggests that oxidative stress has been found to play a pivotal role in the pat
%U http://www.biomedcentral.com/1471-2261/12/10