A survey on the effect of oral vitamin C supplementation in patients undergoing coronary artery bypass graft surgery
DOI:
https://doi.org/10.22122/cdj.v8i4.556Keywords:
Atrial Fibrillation, Coronary Artery Bypass Graft, Vitamin CAbstract
BACKGROUND: The positive effects of antioxidants in preventing atrial fibrillation (AF) after cardiac surgery and their low side effects have been proven. The aim of this study was to evaluate the effect of oral vitamin C supplementation on preventing post-operative AF in patients undergoing coronary artery bypass graft (CABG) surgery. Vitamin C was given orally to the patients three days before surgery for up to 5 days after surgery. This time difference was based on previous studies and cardiologist’s order.
METHODS: In this study, patients who underwent CABG surgery, were divided into two groups. The first group (30 patients), as the intervention group, received oral vitamin C supplementation, and the second group (30 patients), as the control group, did not receive vitamin C supplementation. All patients, during the post-operative period, underwent cardiac monitoring in cardiac intensive care unit (CICU). The inclusion criteria were: being over 50 years old, undergoing cardiac surgery only and no other kinds of surgery, undergoing coronary artery bypass surgery for the first time, and no cardio-respiratory arrest during or after surgery. Data were collected by convenience sampling method and were analyzed using SPSS software.
RESULTS: The results of this study showed that 7 patients in the control group experienced post-operative AF, while 3 patients in intervention group had the same experience. According to the results, the risk of AF in the intervention and control group was, respectively, 10.0% and 23.3%. Vitamin C significantly decreased the risk of AF after CABG surgery by 2 times.
CONCLUSION: According to the results, oral vitamin C supplementation affected the incidence of AF after CABG surgery. Therefore, oral intake of vitamin C supplementation before and after surgery reduces the incidence of AF.
References
Saxena R, Lewis S, Berge E, Sandercock PA, Koudstaal PJ. Risk of early death and recurrent stroke and effect of heparin in 3169 patients with acute ischemic stroke and atrial fibrillation in the International Stroke Trial. Stroke 2001; 32(10): 2333-7.
Singer DE, Albers GW, Dalen JE, Go AS, Halperin JL, Manning WJ. Antithrombotic therapy in atrial fibrillation: The Seventh ACCP Conference on antithrombotic and thrombolytic therapy. Chest 2004; 126(3 Suppl): 429S-56S.
Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, et al. Prevalence of diagnosed atrial fibrillation in adults: National implications for rhythm management and stroke prevention: The AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001; 285(18): 2370-5.
Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: Population-based estimates. Am J Cardiol 1998; 82(8A): 2N-9N.
Morris DC, Clements SD, Bailey JM. Management of the, patient after cardiac surgery. In: Fuster V, Alexander RW, O'Rourke RA, Roberts R, King SB, Nash IS, et al., Editors. Hurst's The Heart. New York, NY: McGraw-Hill; 2004.
Chung MK. Cardiac surgery: Postoperative arrhythmias. Crit Care Med 2000; 28(10 Suppl): N136-N144.
Hakala T, Hedman A. Predicting the risk of atrial fibrillation after coronary artery bypass surgery. Scand Cardiovasc J 2003; 37(6): 309-15.
Oral H. Mechanisms of atrial fibrillation: Lessons from studies in patients. Prog Cardiovasc Dis 2005; 48(1): 29-40.
Maisel WH, Rawn JD, Stevenson WG. Atrial fibrillation after cardiac surgery. Ann Intern Med 2001; 135(12): 1061-73.
Creswell LL, Schuessler RB, Rosenbloom M, Cox JL. Hazards of postoperative atrial arrhythmias. Ann
Thorac Surg 1993; 56(3): 539-49.
Ommen SR, Odell JA, Stanton MS. Atrial arrhythmias after cardiothoracic surgery. N Engl J Med 1997; 336(20): 1429-34.
Eslami M, Badkoubeh RS, Mousavi M, Radmehr H, Salehi M, Tavakoli N, et al. Oral ascorbic acid in combination with beta-blockers is more effective than beta-blockers alone in the prevention of atrial fibrillation after coronary artery bypass grafting. Tex Heart Inst J 2007; 34(3): 268-74.
Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, et al. Lifetime risk for development of atrial fibrillation: The Framingham Heart Study. Circulation 2004; 110(9): 1042-6.
Van Wagoner DR. Recent insights into the pathophysiology of atrial fibrillation. Semin Thorac Cardiovasc Surg 2007; 19(1): 9-15.
Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke 1991; 22(8): 983-8.
Andrews M, Nelson BP. Atrial fibrillation. Mt Sinai J Med 2006; 73(1): 482-92.
Borzak S, Tisdale JE, Amin NB, Goldberg AD, Padhi D, Higgins RS. Atrial fibrillation after bypass surgery: Does the arrhythmia or the characteristics of the patients prolong hospital stay? Chest 1998; 113(6): 1489-91.
Hurst JW. Hurst's the Heart. New York, NY: McGraw-Hill; 2004.
Almassi GH, Schowalter T, Nicolosi AC, Aggarwal A, Moritz TE, Henderson WG, et al. Atrial fibrillation after cardiac surgery: A major morbid event? Ann Surg 1997; 226(4): 501-11.
