Ascorbic acid versus magnesium for the prevention of atrial fibrillation after coronary artery bypass grafting surgery

Abstract

<b>Objective</b><br> The aim of the study was to evaluate the prophylactic use of ascorbic acid or magnesium on frequency of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting surgery with cardiopulmonary bypass.<br> <b>Patients and methods</b><br> The study included 60 patients divided into three equal groups (<i>n</i> = 20): the control group (group C) received saline infusion, the magnesium group (group M) received 2 g magnesium sulfate after induction of anesthesia, 1 g after 12 h followed by 1 g/8 h daily until the fifth postoperative (PO) day and the ascorbic acid group (group A) received 2 g ascorbic acid after induction of anesthesia, then 1 g after 12 h followed by 1 g/8 h daily until the fifth PO day. Operative and PO data were recorded. Primary endpoint was detection of an episode of atrial fibrillation (AF) lasting more than 10 min or the requirement for urgent intervention due to AF.<br> <b>Results</b><br> Sixteen (26.7%) patients developed POAF, eight (40%) patients in group C, five (25%) in group M, and three (15%) in group A, with significantly higher frequency in group C compared with group M (<i>P</i>₁ = 0.041) and group A (<i>P</i>₂ = 0.001) but with nonsignificantly (<i>P</i>₃ = 0.083) higher frequency in group M compared with group A. Four patients developed POAF on the first and 12 patients on the second PO day with nonsignificant intergroup difference. The mean duration of ICU stay was significantly longer in group C compared with groups M (<i>P</i>₁ = 0.016) and A (<i>P</i>₂ = 0.006), with nonsignificantly (<i>P</i>₃ = 0.480) longer duration in group M compared with group A. The mean duration of PO hospital stay was significantly longer in group C compared with groups M (<i>P</i>₁ = 0.008) and A (<i>P</i>₂ = 0.004), with nonsignificantly (<i>P</i>₃ = 0.415) longer duration in group M compared with group A.<br> <b>Conclusion</b><br>Prophylactic use of ascorbic acid or magnesium significantly reduced the frequency of POAF after coronary artery bypass grafting surgery and significantly reduced ICU and hospital stay.