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Vitamin C helps prevent atrial fibrillation after cardiac surgery, meta-analysis shows


  • Meta-analysis of 13 randomized, controlled trials with 1,956 cardiac patients
  • Vitamin C supplementation reduces risk of postoperative atrial fibrillation by 32%
  • Typical oral dosage: 2 g (night before surgery); 1-2 g/day (up to day 5 after surgery)
  • Also reduces length of hospital stay by 1 day, on average


This systematic review and meta-analysis was designed to evaluate the effect of vitamin C supplementation (vitamin C alone or as an adjunct to other therapy) on the prevention of postoperative atrial fibrillation (POAF) in patients after cardiac surgery.

For this study, the researchers searched PubMed, Embase, Web of Science, and Cochrane Library to identify randomized, controlled trials assessing the effect of vitamin C supplementation in adult patients undergoing cardiac surgery. The meta-analysis was performed using a random-effects model.

Thirteen trials involving 1,956 patients were included in the meta-analysis. The typical oral dosage was 2 g of vitamin C the night before surgery and 1-2 g/day up to day 5 after surgery.

The pooling estimate showed a significant reduction in the incidence of POAF (relative risk [RR]: 0.68, 95% confidence interval [CI]: 0.54 to 0.87; P=.002) both with vitamin C supplementation alone (RR: 0.75, 95% CI: 0.63 to 0.90; P=.002) and as an adjunct to other routine therapies (e.g., statin or β-blocker) (RR: 0.32, 95% CI: 0.20 to 0.53; P<.001). The results remained stable and robust in subgroup and sensitivity analyses, and trial sequential analysis confirmed the evidence was sufficient and conclusive.

In addition, vitamin C significantly decreased the length of stay in the intensive care unit (weighted mean difference [WMD]: -0.24 days, 95% CI: -0.45 to -0.03; P=.023), hospital length of stay (WMD: -0.95 days, 95% CI: -1.64 to -0.26; P=.007), and risk of adverse events (RR: 0.45, 95% CI: 0.21 to 0.96; P=.039).

These findings suggest that the prophylactic use of vitamin C alone and as an adjunct to routine therapies can help prevent atrial fibrillation in patients undergoing cardiac surgery as well as shorten the hospital length of stay.


Shi R, Li ZH, Chen D, Wu QC, Zhou XL, Tie HT. Sole and combined vitamin C supplementation can prevent postoperative atrial fibrillation after cardiac surgery: a systematic review and meta-analysis of randomized controlled trials. Clin Cardiol. 2018 Mar 30. [Epub ahead of print].

PMID: 29603289