الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Authors: Moh’d Zaki, MD; Mahmod Elbadri, MD; Moh’d Khaled, MD; Moh’d Farag
· Introduction: Atrial fibrillation (AF) is the most common arrhythmia to occur after
cardiac surgery. An exaggerated systemic inflammatory response has been proposed
to be one etiological factor.
· Aim of the study: This study was done to test whether perioperative intravenous
corticosteroid administration -as a potent antiinflammatory- after cardiac surgery
prevents AF.
· Patients and methods: The study involved 100 consecutive patients without prior
AF who had done their first on-pump coronary artery bypass graft (CABG) surgery,
aortic valve replacement (AVR), or combined CABG and AVR surgery from April
2009 to January 2010 in Cairo university hospitals and National Heart Institute.
Patients were divided into two groups, group 1 (50 patients) who received 100-mg
hydrocortisone in the evening of the operative day, then every 8 hours during the
next 3 days and group 2 (50 patients) who did not given hydrocortisone. All patients
received oral bisoprolol in dose titrated to heart rate. Main outcome measure was the
occurrence of AF during the first 72 hours after cardiac surgery.
· Results: The incidence of postoperative AF was significantly lower in the
hydrocortisone group (14/50 [28%]) than in the other group (24/50 [48%], despite
incidence of DM was statistically significant higher in the hydrocortisone group
(30/50 vs 20/50 patients, P=0.046). The hydrocortisone Group patients had 0.583
(95% CI 0.184 - 0.966) probabilities compared to other group patients to develop
AF in the 1st three postoperative days; P=0.039). TLC was significantly lower in the
hydrocortisone group than the other group during the first three postoperative days
(P<0.05). Patients received hydrocortisone did not have higher rates of superficial or
deep wound infections, or other major complications.
· Conclusion: Intravenous hydrocortisone was effective and safe in reducing the
incidence of AF after cardiac surgery.
Key words:
Atrial fibrillation
AVR
CABG
Corticosteroids
Systemic inflammatory response