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Atrial fibrillation is one of the most common complications of cardiothoracic surgery and is associated with poor outcomes and increased length and cost of hospitalization. In this small, double-blind, placebo-controlled trial, investigators studied 241 patients without prior known AF who were undergoing coronary artery bypass grafting, valve replacement, or both. Participants were randomized to receive either 100-mg hydrocortisone or placebo at the time of surgery and every 8 hours through postoperative day 3. The primary endpoint was the development of AF within 48 hours of surgery.
Overall, significantly fewer hydrocortisone recipients than placebo recipients developed AF after surgery (30% vs. 48%; risk ratio, 0.63). When AF did occur, i…