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Prevention of postoperative atrial fibrillation in open heart surgery patients by preoperative supplementation of n-3 polyunsaturated fatty acids: an updated meta-analysis.

机译：通过术前补充n-3多不饱和脂肪酸预防心内直视手术患者的术后心房纤颤：最新的荟萃分析。

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BACKGROUND: Several randomized clinical trials evaluated whether preoperative supplementation of omega-3 (n-3) polyunsaturated fatty acids protects against postoperative atrial fibrillation after cardiac surgery, a condition associated with increased cardiac and cerebral mortality. However, their efficacy remains still controversial. An updated meta-analysis was performed to clarify if preoperative n-3 polyunsaturated fatty acid supplementation prevents postoperative atrial fibrillation in patients undergoing cardiac surgery.\udMETHODS: Articles were retrieved until November 2012 by screening electronic databases (PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials) and cross references. Two of us independently reviewed articles and agreed to select 8 randomized clinical trials. For each study, the incidence of atrial fibrillation in both the intervention and placebo groups was extracted to calculate odd ratio and 95% confidence intervals (CIs). Weighted study-specific estimates were combined using fixed (Mantel-Haenszel method) and random-effects (DerSimonian-Laird method) models.\udRESULTS: This meta-analysis includes 2687 patients (1337 in the intervention group) who underwent cardiac surgery. Pooled analysis using fixed-effects models showed a significant reduction (average, 16%; 95% CI, 1%-29%) in postoperative atrial fibrillation by preoperative n-3 polyunsaturated fatty acids. There was a low heterogeneity among studies (P = .07 and I(2) = 46%). By using a random-effects model, the reduction averaged 25% (odds ratio, 0.75; 95% CI, 0.57-1.00; P = .05). When isolated coronary artery bypass graft surgery was only considered (7 studies), a significant protection averaging 34% was observed in a fixed model (odds ratio, 0.66; 95% CI, 0.50-0.87; P = .003; I(2) = 26%, P = .23).\udCONCLUSIONS: A preoperative supplementation of n-3 polyunsaturated fatty acids significantly prevents the occurrence of postoperative atrial fibrillation in patients undergoing cardiac surgery, in particular coronary artery bypass surgery.
机译：背景：一些随机临床试验评估了术前补充omega-3（n-3）多不饱和脂肪酸是否可以预防心脏手术后的心房颤动，这是与心脏和脑部死亡率增加相关的疾病。但是，它们的疗效仍存在争议。进行了更新的荟萃分析，以明确术前补充n-3多不饱和脂肪酸是否可以预防心脏手术患者的术后房颤。\ udMETHODS：通过筛选电子数据库（PubMed，EMBASE，Web of Science，和Cochrane对照试验中央注册）和交叉引用。我们中的两个人独立审查了文章，并同意选择8项随机临床试验。对于每项研究，均提取干预组和安慰剂组的房颤发生率，以计算奇数比和95％置信区间（CI）。使用固定（Mantel-Haenszel方法）和随机效应（DerSimonian-Laird方法）模型对特定研究的加权估计值进行合并。\结果：本荟萃分析包括2687例接受心脏手术的患者（干预组为1337例）。使用固定效应模型的汇总分析显示，术前n-3多不饱和脂肪酸可显着降低术后房颤的发生率（平均16％； 95％CI 1％-29％）。研究之间的异质性较低（P = .07和I（2）= 46％）。通过使用随机效应模型，减少量平均为25％（赔率，0.75； 95％CI，0.57-1.00； P = 0.05）。当仅考虑单独的冠状动脉搭桥术时（7项研究），在固定模型中观察到的平均保护率平均为34％（赔率，0.66； 95％CI，0.50-0.87； P = 0.003； I（2） = 26％，P = 0.23。）结论：术前补充n-3多不饱和脂肪酸可显着预防心脏手术（尤其是冠状动脉搭桥手术）患者术后房颤的发生。

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