iJ-blockers, digitalis or both after coronary bypass?

THERAPY

~-blockers, alone or in combination with digitalis, significantly reduce the incidence of supraventricular arrhythmia in patients who have undergone early coronary artery bypass grafting, and combination therapy is superior to ~-blockers alone. Although there was a trend towards a reduced incidence of arrhythmia in patients receiving digitalis alone it was not significantly different from controls.

These results are reported by Dr PR Kowey and colleagues from the US who conducted a meta-analysis of 12 placebo-controlled trials involving 2482 patients who received ~-blockers (n = 675), digitalis (357), a combination of ~-blockers and digitalis (139) or placebo (1311).

The incidence of arrhythmia after surgery in ~-blocker. digitalis, ~-blocker + digitalis recipients and controls was 10. 15. 2 and 19-29%. respectively.

To date, there has been considerable inconsistency in reports on the use of ~-blockers and digitalis in the prevention of supraventricular arrhythmias after bypass surgery, mainly because of the small patient numbers involved in such studies. Dr Kowey and colleagues comment that 'the results of the present study should not be used as a final statement, but perhaps can serve as an impetus to initiate a prospective study with enough power to draw strong conclusions that can be used clinically'. Kowey PRo Taylor JE. Rials SJ. et aJ. Meta-analysis of the effectiveness of prophylactic drug therapy in preventing supraventricular arrhythmia early after coronary artery bypass grafting. American Journal of Cardiology 69: 963-965. I Apr 1992 lbJO

ISSN 0156-2703/92/0516-0013/$1.00/0 © Adis lnlemalionallJd

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INPHARMA® 16 May 1992