Silymarin for the Prevention of Atrial Fibrillation After Cardiac Surgery

Postoperative atrial fibrillation (POAF) is a frequent complication after coronary arterybypass graft (CABG) surgery and is associated with increased mortality. So far, theeffects of various drugs and supplements on the occurrence of postoperative atrialfibrillation (POAF) have been studied, but no one has looked into the effect of silymarinon the occurrence of POAF.The study is designed as a prospective, randomized, controlled trial to assess theeffects of silymarin on the occurrence of postoperative atrial fibrillation after CABGsurgery. A total of 160 patients of both sexes scheduled for elective CABG surgery usingcardiopulmonary bypass (CPB) will be included. They will be randomized into two groups(experimental and control) with 80 patients each. Subjects in the experimental group willreceive 400 mg of silymarin three days preoperatively, while subjects in the controlgroup will receive standard therapy.The occurrence of POAF after CABG surgery will be the primary outcome, which will bedefined as any dysrhythmia that represents the ECG characteristics of atrial fibrillationlasting at least 30 s on a rhythm strip or 12‐lead ECG. Secondary outcomes will includepostoperative values of inflammation markers, length of stay in the ICU, length ofhospitalization, and occurrence of postoperative complications (pericardial effusion,stroke, in‐hospital death).