Medicament for preventing atrial fibrillation after coronary artery bypass transplantation as well as use method and application of medicament

Abstract

The invention provides a medicament for preventing atrial fibrillation after coronary artery bypass transplantation as well as a use method and application thereof, and belongs to the technical field of pharmaceutical preparations. The medicament for preventing atrial fibrillation after coronary artery bypass transplantation comprises potassium magnesium aspartate and amiodarone. The potassium magnesium aspartate is taken before coronary artery bypass transplantation, the taking dosage of the potassium magnesium aspartate is 210-350 mg / time according to the mass of magnesium, the potassium magnesium aspartate is taken three times a day, and the potassium magnesium aspartate is taken for 2-4 days. The amiodarone is taken after coronary artery bypass transplantation, the taking dosage of the amiodarone is 200-600 mg / time, the amiodarone is taken twice a day, and the amiodarone is taken for 3-5 days. The effect of the combination of potassium magnesium aspartate and amiodarone in prevention of coronary artery bypass graft (CABG) postoperative atrial fibrillation is better than that of single use of potassium magnesium aspartate or single use of amiodarone, the occurrence rate of CABG postoperative atrial fibrillation can be significantly reduced, the ICU time and the hospitalization time are shortened, and the hospitalization cost is reduced.

Description

Technical Field

[0001] The present invention belongs to the technical field of pharmaceutical preparations, and in particular relates to a medicament for preventing atrial fibrillation after coronary artery bypass grafting, and a use method and application thereof. Background Art

[0002] Postoperative atrial fibrillation (POAF) is the most common complication after coronary artery bypass grafting (CABG). The incidence has not decreased with the advancement of surgical and anesthesia techniques. It not only increases the patient's hospital stay and medical expenses, but also causes many clinical problems, including serious complications such as stroke and heart failure, leading to increased morbidity and mortality. Therefore, effectively preventing the occurrence of postoperative atrial fibrillation after CABG is a difficult problem faced by cardiologists. Currently, drugs that can prevent postoperative atrial fibrillation include amiodarone, amiodarone, and metoprolol, but the preventive effects are not good. Therefore, there is an urgent need to find new agents to improve the effectiveness and safety of POAF prevention. Summary of the invention

[0003] In view of this, the purpose of the present invention is to provide a medicament for preventing atrial fibrillation after coronary artery bypass grafting, and a method and application thereof, so as to solve the problem that existing drugs are not effective in preventing atrial fibrillation after coronary artery bypass grafting.

[0004] In order to achieve the above-mentioned object of the invention, the present invention provides the following technical solutions:

[0005] The invention provides a medicament for preventing atrial fibrillation after coronary artery bypass grafting, comprising potassium magnesium aspartate and amiodarone.

[0006] Preferably, the dosage form of the potassium magnesium aspartate is a tablet, and the dosage form of the amiodarone is a tablet or a capsule.

[0007] The present invention also provides a method for using the medicament, wherein the potassium magnesium aspartate is taken before coronary artery bypass grafting, and the dosage of the potassium magnesium aspartate is 210-350 mg / time based on the mass of magnesium, 3 times a day, and taken for 2-4 days.

[0008] Preferably, the amiodarone is taken after coronary artery bypass grafting, and the dosage of the amiodarone is 200-600 mg / time, twice a day, for 3-5 days.

[0009] The present invention also provides the use of the medicament in preparing a medicine for preventing atrial fibrillation after coronary artery bypass grafting.

[0010] Compared with the prior art, the present invention has the following beneficial effects:

[0011] The combined use of potassium magnesium aspartate and amiodarone of the present invention is superior to the use of potassium magnesium aspartate or amiodarone alone in preventing atrial fibrillation after coronary artery bypass grafting (CABG), and can significantly reduce the incidence of atrial fibrillation after CABG, shorten ICU time and hospital stay, and reduce hospitalization costs. DETAILED DESCRIPTION

[0012] The invention provides a medicament for preventing atrial fibrillation after coronary artery bypass grafting, comprising potassium magnesium aspartate and amiodarone.

[0013] In the present invention, the dosage form of potassium magnesium aspartate is preferably a tablet; the dosage form of amiodarone is preferably a tablet or a capsule.

[0014] The present invention also provides a method for using the medicament, wherein the potassium magnesium aspartate is preferably taken before coronary artery bypass grafting, and the dosage of the potassium magnesium aspartate is preferably 210-350 mg / time, more preferably 280 mg / time, 3 times a day, for 2-4 days, and the administration time is preferably 3 days. The amiodarone is preferably taken after coronary artery bypass grafting, and the dosage of the amiodarone is preferably 200-600 mg / time, more preferably 400 mg / time, 2 times a day, for 3-5 days, and the administration time is preferably 4 days.

[0015] The present invention also provides the use of the medicament in preparing a medicine for preventing atrial fibrillation after coronary artery bypass grafting.

[0016] The technical solutions provided by the present invention are described in detail below in conjunction with the embodiments, but they should not be construed as limiting the protection scope of the present invention.

[0017] Example 1

[0018] 1. Subjects: A total of 240 patients who underwent CABG in our hospital from January 2018 to December 2022 were selected, including 111 females and 129 males, and were equally divided into 4 groups, with 60 cases in each group. There was no significant difference in the baseline data among the groups (P>0.05), and they were comparable.

[0019] Inclusion criteria: 1) aged 18 to 70 years; 2) candidates for CABG registration; 3) hemodynamic stability (SBP ≥ 90 mmHg); 4) agree to sign the informed consent form for the study.

[0020] Exclusion criteria: emergency, reoperation, any mitral valve disease or surgery.

[0021] Further exclusion criteria: 1) ejection fraction <35%; 2) myocardial infarction within 2 weeks; 3) permanent pacemaker; 4) history of paroxysmal or chronic atrial fibrillation; 5) treatment with amiodarone within 3 months; 6) occlusive bradycardia (HR <50 beats / min); 7) PR interval greater than 220ms, second- or third-degree atrioventricular block, QT interval ≥480ms; 8) transaminase ≥ twice the upper limit of normal; 9) interstitial lung disease; 10) hypothyroidism or hyperthyroidism, renal insufficiency.

[0022] 2. Perioperative treatment plans for different groups

[0023] 1. All patients received standard clinical treatment

[0024] (1) During the perioperative period, electrolytes should be kept stable and blood potassium should be supplemented appropriately (maintaining a concentration of 4.0-5.0 mmol / l).

[0025] (2) During the perioperative period, β-RB should be used according to the guidelines.

[0026] (3) Appropriate volume balance, CVP4-8mmHg.

[0027] 2. Experimental Grouping

[0028] Combined drug group: treated according to clinical standards, and given oral potassium magnesium aspartate (Zhejiang China Resources Sanjiu Zhongyi Pharmaceutical Co., Ltd., national medicine standard number H33021881, specification each tablet contains 79 mg of anhydrous potassium aspartate and 70 mg of anhydrous magnesium aspartate) 4 tablets / time (calculated by the mass of magnesium, 280 mg), three times a day, with a total amount of 2520 mg, and stopped on the day of surgery; oral amiodarone (Shandong Xinyi Pharmaceutical Co., Ltd., national medicine standard number H37021456, specification 0.2 g / tablet) 400 mg / time was given every day from the day after surgery to the 4th day after surgery, twice a day, with a total amount of 3200 mg.

[0029] Amiodarone group: treated according to clinical standards, and given oral amiodarone (Shandong Xinyi Pharmaceutical Co., Ltd., national medicine standard H37021456, specification 0.2g / tablet) 400mg / time, twice a day, total amount 3200mg from the day of surgery to the 4th day after surgery;

[0030] Potassium magnesium aspartate group: treated according to clinical standards, and given oral potassium magnesium aspartate (Zhejiang China Resources Sanjiu Zhongyi Pharmaceutical Co., Ltd., national medicine standard H33021881, specification each tablet contains 79 mg of anhydrous potassium aspartate and 70 mg of anhydrous magnesium aspartate) 4 tablets / time (calculated by the mass of magnesium, 280 mg), three times a day, total amount 2520 mg, starting from 3 days before surgery;

[0031] Control group: The patients were treated according to clinical standards without taking amiodarone and potassium magnesium aspartate.

[0032] 3. The incidence of postoperative atrial fibrillation, the onset time of postoperative atrial fibrillation, perioperative heart rate, duration of single atrial fibrillation, ventilator-assisted time, ICU stay, postoperative hospital stay, and postoperative LVEF were statistically analyzed in patients in different treatment groups. All patients were monitored for the occurrence of POAF using continuous electrocardiogram telemetry technology during postoperative hospitalization, and a standard 12-lead electrocardiogram was recorded every day. The diagnostic method for POAF was to record the onset of AF (≥30S) with a continuous electrocardiogram monitor, portable electrocardiogram monitoring device, or electrocardiogram during hospitalization and confirmed by a clinical physician.

[0033] Experimental results: as shown in Table 1.

[0034] Table 1 Statistical results of patients in different treatment groups after surgery

[0035]

[0036] As shown in Table 1, amiodarone can reduce POAF by 13.4% compared with the control group, potassium magnesium aspartate can reduce POAF by 12% compared with the control group, and the combined medication group can reduce the incidence of POAF by 25% compared with the control group. Moreover, the onset time of postoperative atrial fibrillation in the combined medication group is much higher than that in the amiodarone group and the potassium magnesium aspartate group, and the perioperative heart rate, single atrial fibrillation duration, ventilator-assisted time, ICU stay time, postoperative hospital stay and postoperative LVEF are much lower than those in the amiodarone group and the potassium magnesium aspartate group. It can be seen that the present invention can effectively prevent the occurrence of atrial fibrillation after coronary artery bypass grafting with amiodarone and potassium magnesium aspartate, and further reduce the incidence of atrial fibrillation after CABG.

[0037] It can be seen from the above examples that the combined use of potassium magnesium aspartate and amiodarone of the present invention is better than potassium magnesium aspartate or amiodarone alone in preventing atrial fibrillation after coronary artery bypass grafting (CABG), and can significantly reduce the incidence of atrial fibrillation after CABG, shorten ICU time and hospital stay, and reduce hospitalization costs.

[0038] The above is only a preferred embodiment of the present invention. It should be pointed out that for ordinary technicians in this technical field, several improvements and modifications can be made without departing from the principle of the present invention. These improvements and modifications should also be regarded as the scope of protection of the present invention.

Claims

1. A medicament for preventing atrial fibrillation after coronary artery bypass grafting, characterized in that: These include magnesium potassium aspartate and amiodarone.

2. The drug according to claim 1, characterized in that The dosage form of the potassium magnesium aspartate is a tablet, and the dosage form of the amiodarone is a tablet or a capsule.

3. The method for using the drug according to claim 1 or 2, characterized in that: The potassium magnesium aspartate is taken before coronary artery bypass grafting, and the dosage of the potassium magnesium aspartate is 210-350 mg / time based on the mass of magnesium, 3 times a day, and taken for 2-4 days.

4. The method of use according to claim 3, characterized in that: The amiodarone is taken after coronary artery bypass grafting, and the dosage of the amiodarone is 200-600 mg / time, twice a day, for 3-5 days.

5. Use of the agent according to any one of claims 1 to 4 in the preparation of a drug for preventing atrial fibrillation after coronary artery bypass grafting.

Images