[Latar belakang : Fibrilasi atrium merupakan aritmia yang paling sering terjadi
pasca bedah pintas arteri koroner. Peningkatan stress oksidatif, inflamasi, aktivitas
neurohormonal memiliki peran terhadap kejadian fibrilasi atrium pasca bedah
pintas arteri koroner. Berbagai strategi farmakologis seperti antiaritmia,
antiinflamasi, dan antioksidan sudah dipelajari untuk menurun risiko kejadian
fibrilasi atrium pasca bedah pintas arteri koroner namun kejadian fibrilasi atrium
masih tinggi. Allopurinol memiliki efek antioksidan, namun belum ada uji klinis
yang mempelajari efek allopurinol terhadap kejadian fibrilasi atrium. Penelitian
ini bertujuan untuk menilai efek allopurinol terhadap kejadian fibrilasi atrium
pasca bedah pintas arteri koroner
Metode : Uji klinis randomisasi tersamar ganda dilakukan di Rumah Sakit
Pembuluh Darah Harapan Kita (RSJPDHK) pada periode April ? Mei 2015.
Pasien BPAK on-pump elektif yang diseleksi secara consecutive sampling
kemudian dibagi menjadi dua kelompok yaitu kelompok allopurinol dan
kelompok plasebo dengan randomisasi blok. Subyek diberikan allopurinol 600 mg
/ plasebo dosis tunggal sejak 1 hari sebelum operasi sampai hari ke-5 pasca
operasi. Dilakukan pengamatan kejadian fibrilasi atrium pasca operasi sampai
pasien pulang dari perawatan.
Hasil : Sebanyak 90 subyek diikutsertakan dalam penelitian, 45 subyek pada
masing-masing kelompok. Kejadiaan fibrilasi atrium lebih rendah secara
bermakna pada kelompok allopurinol (12 (26,7%) vs 22 (48,9%) p 0,030).
Kesimpulan : Pemberian allopurinol perioperatif menurunkan kejadian fibrilasi atrium pasca bedah pintas arteri koroner.;Background : Atrial fibrillation is the most common arrhythmias after coronary
artery bypass surgery. Increased oxidative stress, inflammation, neurohormonal
activity has a role on the incidence of atrial fibrillation after coronary artery
bypass surgery. Various pharmacological strategies such as antiarrhythmias, antiinflammatory,
and antioxidant have been studied to decrease atrial fibrillation
incident after coronary artery bypass surgery, but the incidence of atrial
fibrillation is still high. Allopurinol has antioxidant effects, but there was no
clinical trials that studied the effect of allopurinol on atrial fibrillation incidence.
The aim of this study to assess allopurinol effect on the atrial fibrillation incidence
after coronary artery bypass surgery.
Methods: A double-blind randomized clinical trial conducted at the National
Cardiovascular Center Harapan Kita in Jakarta from April to May 2015. Elective
on-pump CABG patients were selected by consecutive sampling then divided into
two groups: allopurinol and placebo groups with block randomization. Subjects
given allopurinol 600 mg / placebo single dose since 1 day before surgery until
the 5th day post-surgery. The incidence of atrial fibrillation was observed
postoperatively.
Results: A total of 90 subjects were included in the study, 45 subjects in each
group. Occurrence of atrial fibrillation was significantly lower in the allopurinol
group (12 (26.7%) vs 22 (48.9%) p 0,030).
Conclusion: Perioperative allopurinol reduced the incidence of atrial fibrillation after coronary artery bypass surgery., Background : Atrial fibrillation is the most common arrhythmias after coronary
artery bypass surgery. Increased oxidative stress, inflammation, neurohormonal
activity has a role on the incidence of atrial fibrillation after coronary artery
bypass surgery. Various pharmacological strategies such as antiarrhythmias, antiinflammatory,
and antioxidant have been studied to decrease atrial fibrillation
incident after coronary artery bypass surgery, but the incidence of atrial
fibrillation is still high. Allopurinol has antioxidant effects, but there was no
clinical trials that studied the effect of allopurinol on atrial fibrillation incidence.
The aim of this study to assess allopurinol effect on the atrial fibrillation incidence
after coronary artery bypass surgery.
Methods: A double-blind randomized clinical trial conducted at the National
Cardiovascular Center Harapan Kita in Jakarta from April to May 2015. Elective
on-pump CABG patients were selected by consecutive sampling then divided into
two groups: allopurinol and placebo groups with block randomization. Subjects
given allopurinol 600 mg / placebo single dose since 1 day before surgery until
the 5th day post-surgery. The incidence of atrial fibrillation was observed
postoperatively.
Results: A total of 90 subjects were included in the study, 45 subjects in each
group. Occurrence of atrial fibrillation was significantly lower in the allopurinol
group (12 (26.7%) vs 22 (48.9%) p 0,030).
Conclusion: Perioperative allopurinol reduced the incidence of atrial fibrillation after coronary artery bypass surgery.]
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