Decreased Redox-Potential and Hyperproduction of Superoxide Anion in Blood Predicts Cardiac Arrhythmias After Direct Surgical Myocardial Revascularization

Abstract

The aim of investigation was the evaluation of prognostic value of redox-potential decreasing and hyperproduction of superoxide anion in plasma with or without of total pool of pyridine nucleotides decreasing in the in-hospital complications after direct surgical myocardial revascularization. 303 patients (248 male and 48 female), mean age 58,6±6,8 years with diagnosis of ischemic heart disease and sinus rhythm without marked left ventricular dysfunction which undergoing coronary bypass graft surgery were included in the multicentral prospective study. European System for Cardiac Operative Risk Evaluation (EuroScore) and the incidence rates of post-procedural ischemic stroke CHADS2 and CHA2 DS2-VASc score were calculated. Total pyridine nucleotide pool, redox-potential, hyperproduction of superoxide anion and activity of NADPH-oxidase in blood plasma were determinate before and one year after cardiac surgery. For statistical analysis the SPSS version 23.0 (SPSS Inc. Chicago, Ill) was used, all variables are expressed as mean±standard deviation (SD). The maximum of appearance of postoperative atrial fibrillation (POAF) developed in 34% patients after 1-2 days from cardiac surgery. In the cohort of patients with POAF complicated with decease of redox-potential NAD/NADH by 23% (р<0,01) in comparison with sinus rhythm maintenance group. In group with POAF the AF after 1 years maintained in 45% cases, and developed in 14,5% cases in group with post-operative sinus rhythm. In according with ROC-analysis the area incidence of POAF-NAD/NADH equal 0,92 (р<0,0001), sensitivity of 83,4% and specificity of 91,4%. Redox-potential NAD/NADH level with considered the concentration of superoxide anion and activity of NADPH oxidase in pre-operative plasma of patients undergoing surgical myocardil revascularization could accurately predict the onset of de novo POAF. Thus, plasma NAD/NADH could consider as a candidate for predictive biomarker of common arrhythmia under cardiac surgery.