Cochrane · systematic review · CD004126
Alpha‐2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery
Duncan, D, Sankar, A, Beattie, WS, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
AnaesthesiaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
11
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 1 · 8.3%Very low 0 · 0%Low 2 · 16.7%Moderate 6 · 50%High 3 · 25%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Alpha‐2 adrenergic agonists compared to control in non‐cardiac surgery
Population: adults undergoing non‐cardiac surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality (within 30‐days after surgery: any reported death) Alpha‐2 adrenergic agonists vs control | no estimate extracted | 16 studies · 14081 participants | High |
Cardiac mortality (within 30‐days after surgery: sudden death or death resulting from a primarily identifiable cardiac cause.) Alpha‐2 adrenergic agonists vs control | no estimate extracted | 5 studies · 12525 participants | High |
Myocardial infarction (within 30‐days after surgery: as detected on an electrocardiogram or trans‐oesophageal echocardiogram) Alpha‐2 adrenergic agonists vs control | no estimate extracted | 12 studies · 13907 participants | Moderate Downgraded: risk of bias |
Acute stroke (within 30‐days after surgery: new focal neurologic deficit with signs and symptoms lasting longer than 24 hours) Alpha‐2 adrenergic agonists vs control | no estimate extracted | 7 studies · 11542 participants | High |
Bradycardia (requiring pharmacological or pacemaker treatment during the period of study drug administration) Alpha‐2 adrenergic agonists vs control | no estimate extracted | 16 studies · 14035 participants | Moderate Downgraded: risk of bias |
Hypotension (requiring treatment with inotropes or vasopressors during the period of study drug administration) Alpha‐2 adrenergic agonists vs control | no estimate extracted | 15 studies · 13738 participants | Moderate Downgraded: risk of bias |
Alpha‐2 adrenergic agonists compared to control in cardiac surgery
Population: adults undergoing cardiac surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality (within 30‐days after surgery: any reported death) Alpha‐2 adrenergic agonists vs control | RR 0.52 [0.26, 1.04] | 16 studies · 1947 participants | Moderate Downgraded: risk of bias |
Cardiac mortality (within 30‐days after surgery: sudden death or death resulting from a primarily identifiable cardiac cause) Alpha‐2 adrenergic agonists vs control | no estimate extracted | 1 study · 22 participants | Ungraded |
Myocardial infarction (within 30‐days after surgery: sudden death or death resulting from a primarily identifiable cardiac cause) Alpha‐2 adrenergic agonists vs control | RR 1.01 [0.43, 2.4] | 8 studies · 782 participants | Moderate Downgraded: risk of bias |
Acute stroke (within 30‐days after surgery: new focal neurologic deficit with signs and symptoms lasting longer than 24 hours) Alpha‐2 adrenergic agonists vs control | RR 0.37 [0.15, 0.93] | 7 studies · 1175 participants | Low Downgraded: risk of bias |
Bradycardia (requiring pharmacological or pacemaker treatment during the period of study drug administration) Alpha‐2 adrenergic agonists vs control | RR 1.88 [1.35, 2.62] | 10 studies · 1477 participants | Moderate Downgraded: risk of bias |
Hypotension (requiring treatment with inotropes or vasopressors during the period of study drug administration) Alpha‐2 adrenergic agonists vs control | RR 1.19 [0.87, 1.64] | 9 studies · 1413 participants | Low Downgraded: risk of bias |