During heart surgery, high doses of corticosteroids aiming to reduce inflammation are often administered. This practice, however, is controversial since there is no evidence available to show clear benefits. Moreover, corticosteroids have the potential of important side-effects. The aim of this meta-analysis was to summarize (pool) data from studies on this subject and to estimate the effect of corticosteroid administration on the risk of major complications (death, heart infarction, lung problems) following heart surgery.
Major databases of medical literature were searched for publications of studies that randomly assigned adult patient undergoing heart surgery to receive either corticosteroid treatment compared to no treatment or placebo. A total of 54 publications were selected for the analysis. The quality of most of these publications was rather poor, thereby limiting the value of the pooled risk estimate. For none of the major complications (death, heart infarction, lung problems), a change of risk by corticosteroid administration could be demonstrated. Only the risk of (often encountered) heart rhythm disturbances (atrial fibrillation) was clearly shown to be reduced (around 40% less).
The authors therefore conclude that no beneficial effects of high-dose corticosteroids could be shown on the risk of major complications following heart surgery, although this conclusion is limited to low quality of the data available. For a more definitive conclusion, studies with much larger numbers of patients need to be performed.