Landiolol hydrochloride for prevention of atrial fibrillation after coronary artery bypass grafting: New evidence from the PASCAL trial Akira Sezai,

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Presentation transcript:

Landiolol hydrochloride for prevention of atrial fibrillation after coronary artery bypass grafting: New evidence from the PASCAL trial Akira Sezai, MD, PhD, Kazutomo Minami, MD, PhD, Toshiko Nakai, MD, PhD, Mitsumasa Hata, MD, PhD, Isamu Yoshitake, MD, PhD, Shinji Wakui, MD, PhD, Motomi Shiono, MD, PhD, Atsushi Hirayama, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 141, Issue 6, Pages 1478-1487 (June 2011) DOI: 10.1016/j.jtcvs.2010.10.045 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Disposition of the subjects: The PASCAL trial was conducted in 140 patients who underwent isolated coronary arterial bypass grafting. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1478-1487DOI: (10.1016/j.jtcvs.2010.10.045) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Days of occurrence of Af. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1478-1487DOI: (10.1016/j.jtcvs.2010.10.045) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Changes of blood pressure (systolic blood pressure and diastolic blood pressure [upper]) and heart rate [lower]. Systolic and diastolic blood pressure showed no significant differences between the 2 groups, but heart rate was significantly lower in the landiolol group. sBP, Systolic blood pressure; dBP, diastolic blood pressure; HR, heart rate. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1478-1487DOI: (10.1016/j.jtcvs.2010.10.045) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Perioperative and postoperative fluid balance: Fluid balance showed no statistically significant difference between the 2 groups. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1478-1487DOI: (10.1016/j.jtcvs.2010.10.045) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Ischemia–reperfusion injury parameters: CK-MB on postoperative day 1, troponin-I on postoperative days 1 and 3, and human heart fatty acid-binding protein on postoperative day 1 (at the time of returning to ICU) were significantly lower in the landiolol group compared with the placebo group. CK-MB, Creatine kinase isoenzyme MB; H-FABP, human heart fatty acid-binding protein. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1478-1487DOI: (10.1016/j.jtcvs.2010.10.045) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 hs-CRP (upper) and urinary 8-hydroxydeoxyguanosine (lower). hs-CRP was significantly lower on postoperative day 3 in the landiolol group compared with the placebo group, but urinary 8-hydroxydeoxyguanosine showed no significant difference between the 2 groups. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1478-1487DOI: (10.1016/j.jtcvs.2010.10.045) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 7 IL-6 (upper) and IL-8 (lower). IL-6 (on postoperative days 1 and 3) and IL-8 (on returning to ICU) were significantly lower in the landiolol group than in the placebo group. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1478-1487DOI: (10.1016/j.jtcvs.2010.10.045) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions