Results from a recent study published in the journal CHEST show that the administration of olprinone continuously during lung cancer surgery reduces the risk for atrial fibrillation in patients with elevated preoperative B-type natriuretic peptide levels.
“Continuous infusion of low-dose olprinone was found to be highly tolerable, and no significant adverse effects were observed,” Takashi Nojiri, MD, PhD,a general thoracic surgery staff surgeon at Osaka University Graduate School of Medicine in Japan, and colleagues wrote. “These findings indicate that low-dose olprinone is a preferred treatment option to prevent postoperative atrial fibrillation in high-risk patients undergoing non-cardiac surgery.”
Phosphodiesterase (PDE) type III is present in the bronchial smooth muscle, vascular smooth muscle, alveolar macrophages, myocardium and platelets. PDE-III inhibitors are considered a possible treatment for patients with cardiac disease and pulmonary disease because of their inotropic, vasodilating, and bronchodilator effects.
Olprinone is a specific PDE-III inhibitor used for the treatment of acute heart failure.
“It [has been] reported to stabilize hemodynamic parameters without affecting heart rate or blood pressures at low doses, and [has shown] significant anti-inflammatory effects,” Nojiri noted in a news release. “We hypothesized that low-dose olprinone could have the beneficial effects on lung cancer surgery.”
The team of researchers conducted a randomized, double blind, placebo-controlled, parallel-group, prospective study in 40 patients who had high levels of BNP prior to surgery (≥30 pg/mL). All patients underwent lung cancer surgery and were in sinus rhythm during surgery.
Low-dose olprinone or placebo was continuously infused for a period of 24 hours. The primary outcome of the study was the incidence of postoperative atrial fibrillation. The secondary outcomes of the study were preoperative hemodynamics and the counts of white blood cells, levels of BNP, and levels of the C-reactive protein.
Results revealed that the prevalence of postoperative atrial fibrillation was lower in the group of patients under olprinone (n=20) in comparison to the placebo patients’ group (10% versus. 60%). After surgery, the results showed that patients in the olprinone group had lower white blood cell counts, lower levels of BNP as well as lower levels of C-reactive protein.
“A larger, multicenter study is necessary to validate and generalize the findings of the present study,” the researchers wrote. “Furthermore, echocardiographic and cardiac catheter examinations were not performed following surgery in the present study, and there are no data regarding any beneficial effects on invasive hemodynamic parameters during the perioperative period.”