Effect of Alpha-Lipoic Acid Supplementation on the Incidence of Postoperative Atrial Fibrillation in Cardiac Surgery Patients

Study Overview
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Brief Summary
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ALA is administered orally since it is without difficulty absorbed in the stomach. ALA goes through the blood brain barrier and does not show toxic effects and actions at doses used for prophylactic and therapeutic purposes. This has encouraged us to use an efficient anti-oxidant and anti-inflammatory agent, alpha-lipoic acid (biochemical) as a relevant option to prevent POAF.

Detailed Description
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Investigators computed on the basis of findings from a prior study found the incidence of POAF after cardiac surgery of about 25% . Assuming a slightly lower alpha-lipoic acid' effect to previous study. If the true relative risk of AF for experimental subjects relative to controls is 0.5 , with α equivalent to 0.5 and power (1 - β) is 0.8, the estimated sample size is 152 experimental subjects and 152 control subjects in order to be able to reject the null hypothesis that this relative risk equals 1 with probability (power) of 0.8. investigators used the uncorrected chi-squared statistics to evaluate this null hypothesis. STATA software version and taking into account a possible dropout of 15%, the total sample size was: 304 + 0.15 (304) × 2 = 350 subjects of which there will be 175 controls and 175 experimental subjects %, assuming an enrolment ratio of 1:1.

Official Title
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Effect of Alpha-Lipoic Acid Supplementation on the Incidence of Postoperative Atrial Fibrillation in Cardiac Surgery Patients

Conditions
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Postoperative Atrial Fibrillation

Intervention / Treatment
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* Drug: Alpha Lipoic Acid 600 MG Oral Tablet
* Drug: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: I Male or female patients above 18 years of age who are scheduled for cardiac surgery. Exclusion Criteria: Any urgent or emergency surgery. Poor Left ejection volume (EF < 30%). Intake of steroids or any antiarrhythmic drugs except beta blockers during the last month before surgery Unable or unwilling to provide informed written consent. Pregnancy or lactation Known hypersensitivity to the study drug. Current treatment with antioxidants or alpha-lipoic acid for any indication. Infection or inflammatory disease except coronary artery disease. Left atrium size >70 mm.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Group 1 (Control group, N = 175 patients)<br>which will include patients adopted to the hospital standard of care. | Drug: Placebo<br>* placebo<br>|
| Active Comparator: Group 2 (Test group, N = 175 patients)<br>which will include patients who will receive Alpha-lipoic acid (Thiotacid 600 mg ®) at a dose of 600 mg three times daily for one day prior to surgery, followed by Alpha-lipoic acid 600 mg twice daily for 5 days post-surgery plus the standard care. | Drug: Alpha Lipoic Acid 600 MG Oral Tablet<br>* Alpha-lipoic acid (Thiotacid 600 mg ®) at a dose of 600 mg three times daily for one day prior to surgery, followed by Alpha-lipoic acid 600 mg twice daily for 5 days post-surgery plus the standard care.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| • Number of Participants with POAF |  | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total intensive care unit length-of-stay | number of days at intensive care unit | 3 months | 
| Total hospital length-of-stay | number of days at hospital | 3 months | 
| 30 days mortality | deaths number | 1-month | 
| Serum creatinine | creatinine level | 5 days | 
| Major adverse cardiovascular outcomes | (Myocardial injury - Stroke - Permanent pacemaker - Pericardial effusion and pleural effusion- Bleeding) | 1 month | 
| Duration of ventilation | hours needed to remove ventilator | 5 days |