Antiarrhythmic and Cardioprotective Effects of Atorvastatin Versus Magnesium Sulfate in Cardiac Valve Replacement Surgery

NCT ID: NCT03289429

Last Updated: 2018-02-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

96 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-09-24

Study Completion Date

2018-02-28

Brief Summary

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This study aims to compare the antiarrhythmic and cardioprotective effects of Atorvastatin versus Magnesium Sulfate after Cardiac valve Replacement Surgery

Detailed Description

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Arrhythmia is a common complication after cardiac valve surgery. Postoperative atrial fibrillation (POAF) is the most common type of arrhythmia after cardiac surgery. It has different leading causes, including myocardial injury, inadequate myocardial protection, the effect of cardiopulmonary bypass, and electrolyte imbalance. Beta blockers, amiodarone, and magnesium sulfate are used for the management of POAF.

Statin is used commonly for its lipid lowering action, however, some studies shows that statin has powerful pleiotropic effects including its antiarrhythmic effect.

This study aims to compare the antiarrhythmic and cardioprotective effects of Atorvastatin versus magnesium sulfate after cardiac replacement surgery.

Conditions

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Arrhythmias

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Atorvastatin

Atorvastatin and intravenous placebo

Group Type EXPERIMENTAL

Atorvastatin

Intervention Type DRUG

Atorvastatin in a dose of 80 mgs, twelve hours preoperatively, two hours preoperatively, and on the 2nd, 3rd, 4th and 5th postoperative days.

intravenous placebo

Intervention Type OTHER

100 mL of isotonic saline (to be infused over 2 hours) twelve hours preoperatively, within the first hour of ICU arrival, and on the 2nd and 3rd postoperative days.

Magnesium sulfate

Magnesium sulfate and tablets placebo

Group Type EXPERIMENTAL

Magnesium Sulfate

Intervention Type DRUG

Magnesium sulfate: ( 3 grams dissolved in 100 mL of isotonic saline to be infused over 2 hours) twelve hours preoperatively, within the first hour of ICU arrival, and on the 2nd and 3rd postoperative days.

tablets placebo

Intervention Type OTHER

Placebo tablets: twelve hours preoperatively, two hours preoperatively, and on the 2nd, 3rd, 4th and 5th postoperative days.

Control

intravenous placebo and tablet placebo

Group Type PLACEBO_COMPARATOR

intravenous placebo

Intervention Type OTHER

100 mL of isotonic saline (to be infused over 2 hours) twelve hours preoperatively, within the first hour of ICU arrival, and on the 2nd and 3rd postoperative days.

tablets placebo

Intervention Type OTHER

Placebo tablets: twelve hours preoperatively, two hours preoperatively, and on the 2nd, 3rd, 4th and 5th postoperative days.

Interventions

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Atorvastatin

Atorvastatin in a dose of 80 mgs, twelve hours preoperatively, two hours preoperatively, and on the 2nd, 3rd, 4th and 5th postoperative days.

Intervention Type DRUG

Magnesium Sulfate

Magnesium sulfate: ( 3 grams dissolved in 100 mL of isotonic saline to be infused over 2 hours) twelve hours preoperatively, within the first hour of ICU arrival, and on the 2nd and 3rd postoperative days.

Intervention Type DRUG

intravenous placebo

100 mL of isotonic saline (to be infused over 2 hours) twelve hours preoperatively, within the first hour of ICU arrival, and on the 2nd and 3rd postoperative days.

Intervention Type OTHER

tablets placebo

Placebo tablets: twelve hours preoperatively, two hours preoperatively, and on the 2nd, 3rd, 4th and 5th postoperative days.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing isolated valvular replacement surgery.
* Preoperative rhythm: Sinus rhythm.
* Preoperative troponin I \< 0.01 ng/mL.
* Normal lipid profile.
* White blood cells (4-11 X 103/mm3).
* Preoperative C-reactive protein \< 3 mg/L.

Exclusion Criteria

* History of atrial fibrillation.
* Any degree of heart block or patients with implanted pacemaker.
* Prior use of Antiarrhythmic drugs.
* Preoperative lipid lowering therapy (e.g statins) during the last 3 months.
* Previous treatment with any type of magnesium containing supplementation (the week before the intervention).
* Underlying heart failure or Left ventricular ejection fraction \< 0.3.
* Previous myocardial infarction.
* Diabetes or other metabolic disorders.
* Renal diseases.
* Hepatic dysfunction.
* Underlying thyroid problems (hypo/hyperthyroidism).
* Underlying inflammatory disease (active or controlled)
* Immunosuppressive and anti-inflammatory medications for the treatment of coexisting conditions.
* Psychological disorders,
* Emergency cardiac surgery
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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FATMA NABIL AHMED MOHAMED

Assistant lecturer of anesthesia and intensive care, Assiut University

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Assiut University

Asyut, , Egypt

Site Status RECRUITING

Countries

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Egypt

Facility Contacts

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Fatma N. Mohamed, M.Sc.

Role: primary

+201003633992

Esam Eldin M. Abdallah, M.D.

Role: backup

Other Identifiers

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Statin and Magnesium

Identifier Type: -

Identifier Source: org_study_id

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