Authors: Vader, C.¹; Grouls, R.¹; van Gerven, A.¹; Ackerman, E.¹; Korsten, H.²; Schönberger, J.³; ter Woorst, F.³; Botman, C.⁴; Leufkens, H.⁵

Source: British Journal of Clinical Pharmacology, Volume 53, Number 5, May 2002 , pp. 555P-556P(2)

Publisher: Wiley-Blackwell

Abstract:

Atrial fibrillation (AF) represents the most common arrhythmic complication of coronary artery bypass grafting (CABG). Incidence rates vary between 17% and 33% [ 1]. Peak incidence occurs 2 to 3 days postoperatively [ 2]. Postoperative AF has been associated with increases in total length of stay (LOS), costs, morbidity and mortality.

The objective was to investigate if the pharmacodynamic interaction between albuterol and sotalol is associated with an increase in the incidence of AF and LOS in CABG-patients at an Intensive Care Unit (ICU).

The study was a retrospective nested, matched case-control study carried out in the ICU of the Catharina Hospital, Eindhoven, The Netherlands, in the period 1998-2000.

The subjects were patients hospitalised at an ICU after CABG, treated with sotalol with or without albuterol or albuterol/ipratropium bromide. Patients were matched by date of CABG, pre-operative pulmonary function (Tiffeneau-index >0.7) and pre-operative CRASH score, a hospital score used as a prognostic value for post-operative morbidity and mortality.

The results were analyzed using the Intensive Care Information System (ICIS; INAD Computers & Software BV, Eindhoven) and the Cardio Reporting System of the Catharina Hospital, Eindhoven.

Demographic characteristics of cases and controls (no statistically significant differences between both groups) are presented in Table 1.

The concurrent use of sotalol and albuterol led to an increased risk for postoperative atrial fibrillation (OR 6.2; 95% confidence interval: 2.3, 17.7). The Mantel-Haenszel odds ratio, corrected for age, was 1.67 ( Table 2). LOS was significantly increased.

The concurrent use of sotalol and albuterol leads to an increased risk for postoperative AF and is associated with an increased LOS at the ICU of our hospital.

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1365-2125.2002.161320.x

Affiliations: 1: Clinical Pharmacy, 2: Anaesthesiology, 3: Cardiothoracic Surgery and 4: Cardiology, Catharina Hospital Eindhoven and 5: Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, The Netherlands

Publication date: 2002-05-01

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