ArticleFrontiers in pharmacology2025
Phenylephrine and the risk of atrial fibrillation in critically ill patients: a multi-centre study from eICU database.
Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Vasopressors are vital for maintaining blood pressure in critically ill patients, though they carry risks like irregular heartbeats and impaired cardiac oxygen balance. Existing studies have not definitively proven that phenylephrine triggers new atrial fibrillation (AF). Aims: This study was designed to assess pharmacological associations between phenylephrine utilization and new AF occurrence risk. Methods: This multicenter retrospective study analyzed eICU database records. Propensity score matching (PSM) balanced baseline confounders. Cox regression models (unadjusted/adjusted) assessed phenylephrine-AF associations. Results: In this cohort encompassing 51,294 critically ill adults (mean age 62.4 ± 16.6 years; 53.5% male), propensity score matching established comparable cohorts: 2,110 phenylephrine-exposed patients and 6,330 matched controls. The analysis revealed a clinically significant disparity in new AF incidence, with phenylephrine-exposed patients demonstrating a 10.5% event rate (282/2,673) Conclusion: This evidence positions phenylephrine as a modifiable new AF risk factor in critical care, supporting risk-aware vasopressor selection through benefit-harm analysis.
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