Comparison of Effectiveness and Safety of Ranolazine Versus Amiodarone for Preventing Atrial Fibrillation After Coronary Artery Bypass Grafting
The American Journal of Cardiology, 08/25/2011

Miles RH et al. – Ranolazine was independently associated with a significant reduction of atrial fibrillation (AF) compared to amiodarone after coronary artery bypass grafting (CABG), with no difference in the incidence of adverse events. Randomized studies should be conducted to confirm these results.

• A retrospective cohort study of patients undergoing CABG at Aspirus Hospital from June 2008 to April 2010.
• The patients received either amiodarone (400 mg preoperatively followed by 200 mg twice daily for 10 to 14 days) or ranolazine (1,500 mg preoperatively followed by 1,000 mg twice daily for 10 to 14 days).
• The primary end point was any identified AF after CABG.
• A total of 393 consecutive patients undergoing CABG (mean age 65 ± 10 years, 72% men) received either amiodarone (n = 211 [53.7%]) or ranolazine (n = 182 [46.3%]).

• AF occurred in 26.5% of the amiodarone–treated patients compared to 17.5% of the ranolazine–treated patient (p = 0.035).
• The univariate predictors of AF included amiodarone use, age, chronic lung disease, and congestive heart failure.
• The multivariate predictors of AF included amiodarone use (odds ratio 1.7, 95% confidence interval 1.01 to 2.91, p = 0.045 vs ranolazine), age (odds ratio 2.2 per 10 years, 95% confidence interval 1.63 to 2.95, p <0.001), and chronic lung disease (odds ratio 1.86, 95% confidence interval 1.00 to 3.43, p = 0.049).
• No difference was found in the risk of adverse events between the 2 therapies.