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. 2019 Sep 23;2019(9):CD013435. doi: 10.1002/14651858.CD013435

Stephenson 1980.

Methods Quasi‐randomized trial, parallel design
Participants Total number of analysed participants: 223 (number of randomized participants not clearly reported)
Inclusion criteria: scheduled for CABG surgery without additional cardiac surgical procedures
Exclusion criteria: cardiac arrhythmias in immediate 18 h postoperative period; bradycardia requiring a pacemaker; low cardiac output requiring catecholamine support
Type of surgery: elective CABG
Baseline characteristics
Intervention group (propranolol)
  • Age, mean: 54 years

  • Gender, M/F: 80/7

  • Preoperative use of beta‐blockers, n: 63


Control group (standard care)
  • Age, mean: 56 years

  • Gender, M/F: 122/14

  • Preoperative use of beta‐blockers, n: 86


Country: USA
Setting: single centre; hospital
Interventions Intervention group (propranolol)
  • Randomized, n = unclear; losses = at least 4 (2 because of wrong dose; 2 because of bradycardia; number of other losses was not reported); analysed, n = 91 for cardiac arrhythmias (we re‐included 4 excluded participants because study authors reported no cardiac arrhythmias amongst excluded participants) (ITT analysis not used)

  • Details: 10 mg propranolol every 6 h starting on 1st postoperative day


Control group (standard care)
  • Randomized, n = 136; losses = we assumed no losses; analysed, n = 136

  • Details: no details

Outcomes Outcomes measured/reported by study authors: postoperative cardiac arrhythmias (supraventricular and ventricular)
Outcomes relevant to the review: postoperative ventricular arrhythmias; MI; bradycardia (see notes below)
Notes Funding/declarations of interest: not reported
Study dates: not reported
Note:
  • although study authors reported data for bradycardia (as a reason for excluding 2 participants in the propranolol group), we did not include these data in analysis because we could not be certain of incidences of bradycardia in the control group

Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) High risk Quasi‐randomized ‐ randomization by date of birth
Allocation concealment (selection bias) High risk See above
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Open‐label trial
Blinding of outcome assessors (detection bias) 
 All outcomes High risk Open‐label trial
Incomplete outcome data (attrition bias) 
 All outcomes High risk Number of randomized participants was unclearly reported with an unspecified number of exclusions in the propranolol group. We re‐included data for 4 excluded participants in the propranolol group for arrhythmia data
Selective reporting (reporting bias) Unclear risk Study authors did not report prospective clinical trial registration or publication of a protocol. It was not feasible to effectively assess risk of reporting bias
Other bias Low risk Not detected