Landiolol for the prevention of postoperative atrial fibrillation after cardiac surgery: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials.
Mohammed A Elbahloul, Ahmed Samy Badran, Ahmed Shawky et al.
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In 30 seconds
This GRADE-assessed systematic review and meta-analysis examined randomized trials of intravenous landiolol to prevent postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery. Across 11 RCTs involving 1,264 patients, landiolol was associated with lower POAF incidence than control (OR: 0.35, 95% CI: 0.23-0.53, p < 0.01). The analysis found no significant differences in hospital mortality, length of hospital stay, heart failure, or major complications. The authors concluded that landiolol appears effective for POAF prevention, while calling for larger, multi-ethnic randomized trials to confirm the findings.
Key findings
- Across 11 RCTs and 1,264 patients, landiolol was associated with lower POAF incidence than control (OR: 0.35, 95% CI: 0.23-0.53, p < 0.01).
- No significant differences were found in hospital mortality, length of hospital stay, heart failure, or major complications.
Why it matters
POAF is a common complication after cardiac surgery, and the pooled randomized-trial evidence suggests landiolol may reduce its incidence. The absence of significant differences in the reported broader clinical outcomes means the findings chiefly support a preventive effect on POAF, rather than demonstrating improvement in mortality or other complications.
What to keep in mind
The authors state that large-scale, multi-ethnic RCTs are needed to confirm the findings.