Catecholamine Vasopressors and the Risk of Atrial Fibrillation After Noncardiac Surgery: A Prospective Observational Study.

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2024-11-15 eCollection Date: 2024-01-01 DOI:10.2147/DDDT.S474818

Weichao Li, YuYan Liu, Xunhu Gu

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引用次数: 0

Abstract

Background: Catecholamine vasopressors are commonly used for intra- or post-operative hypotension for cardiac surgery, which have a side effect of new-onset atrial fibrillation (AF) and myocardial ischemia. However, it is not entirely clear whether catecholamine vasopressors increase the risk of new-onset AF after noncardiac surgery.

Aim: The aim of this study was to analyze the association between the use of catecholamine vasopressors and the risk of developing new-onset AF after noncardiac surgery.

Methods: In this prospective trial, available data from eligible elderly individuals receiving noncardiac surgery at a single center from November 2022 to January 2024 were gathered. Propensity score matching (PSM) was used to balance patient baseline characteristics and to control for confounders. To determine the association between catecholamine vasopressors and the risk of new-onset AF, univariate and multivariate logistic regression analyses were performed.

Results: A total of 6000 subjects were included in this study (mean [SD] age, 70.73 [6.37] years; 910 [50.9%] males). After PSM, the patients were stratified into catecholamine vasopressor (n = 357) and comparator groups (n = 1432). A total of 18/357 patients in the catecholamine vasopressor group developed AF, and 25/1432 patients in the comparator group developed AF (incidence rate, 5.0% vs 1.7%). Compared with the comparator group, the catecholamine vasopressor group had an increased risk of new-onset AF (aOR, 2.77; 95% CI, 1.28-5.89). Some sensitivity analyses also revealed consistent findings of increased new-onset AF risk associated with catecholamine vasopressor treatment.

Conclusion: The findings from this study suggest that catecholamine vasopressor treatment is associated with an increased risk of new-onset AF and may help physicians select a modest medication for patients while also assessing the risk of new-onset AF.

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儿茶酚胺类血管加压药与非心脏手术后心房颤动的风险：一项前瞻性观察研究

背景：儿茶酚胺类血管加压药常用于心脏手术的术中或术后低血压，其副作用是新发房颤（AF）和心肌缺血。目的：本研究旨在分析儿茶酚胺类血管加压药的使用与非心脏手术后新发房颤风险之间的关系：在这项前瞻性试验中，研究人员收集了2022年11月至2024年1月期间在一个中心接受非心脏手术的符合条件的老年人的现有数据。采用倾向评分匹配法（PSM）平衡患者基线特征并控制混杂因素。为确定儿茶酚胺类血管加压药与新发房颤风险之间的关系，进行了单变量和多变量逻辑回归分析：本研究共纳入 6000 名受试者（平均 [SD] 年龄 70.73 [6.37] 岁；男性 910 [50.9%]）。PSM 后，患者被分为儿茶酚胺类血管抑制剂组（n = 357）和对比组（n = 1432）。儿茶酚胺类血管舒张剂组共有 18/357 例患者发生房颤，而对比组则有 25/1432 例患者发生房颤（发生率为 5.0% vs 1.7%）。与对照组相比，儿茶酚胺类血管抑制剂组新发房颤的风险更高（aOR，2.77；95% CI，1.28-5.89）。一些敏感性分析也显示，儿茶酚胺类血管舒张剂治疗会增加新发房颤的风险：本研究结果表明，儿茶酚胺类血管舒张剂治疗与新发房颤风险增加有关，可帮助医生在评估新发房颤风险的同时为患者选择适度的药物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.