Do preoperative C-reactive protein and mean platelet volume levels predict development of postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting?

Abstract

IntroductionAtrial fibrillation (AF) after coronary artery bypass grafting (CABG) operation is associated with increased risk of prolonged hospitalisation, health expenses and adverse clinical outcomes.AimTo investigate the relationship of atrial fibrillation after an isolated coronary artery bypass operation with levels of mean platelet volume and C-reactive protein.Material and methodsAmong 1240 patients who underwent operations for isolated coronary artery bypass grafting with cardiopulmonary bypass between January 2007 and May 2014, 1138 (91.8%) patients with preoperative normal sinusal rhythm were enrolled in the study. Patients were assigned to group 1 (n = 294) comprising patients who developed atrial fibrillation in the first 72 postoperative hours or group 2 (n = 844) comprising patients who remained in normal sinusal rhythm in the postoperative period.ResultsThe incidence of postoperative atrial fibrillation was 25.8%. The preoperative mean platelet volume (fl) and C-reactive protein (mg/dl) values in group 1 were 9.1 ±0.5 and 1.1 ±0.9 respectively, while these values were 8.3 ±0.6 and 0.5 ±0.3 respectively in group 2, which was statistically significant (p = 0.0001). Length of stay in the hospital (p = 0.0001) was higher in group 1. The values of mean platelet volume (fl) and mean C-reactive protein (mg/dl) were 9.9 ±0.9 and 30.9 ±3.4 respectively in group 1, while the values of mean platelet volume (fl) and mean C-reactive protein (mg/dl) were 8.8 ±0.6 and 24.9 ±4.8 respectively in group 2 (p = 0.0001 for mean platelet volume, p = 0.0001 for C-reactive protein). The difference between the groups was statistically significant in terms of postoperative neurologic events (p = 0.0001) and hospital mortality (p = 0.001). Increased C-reactive protein and mean platelet volume levels were found to be independent predictors of postoperative atrial fibrillation.ConclusionsIn our study, elevated preoperative mean platelet volume and C-reactive protein levels were associated with development of postoperative atrial fibrillation.

Biochemical predictors of postoperative atrial fibrillation following cardiac surgery

“…Almost all previous studies and meta-analyses uniformly indicate that elevated CRP is closely associated with the risk of POAF, and our results are consistent with such findings [ 3 , 21 ]. Preoperative high CRP levels possibly reflect a high basal level of systemic inflammation [ 22 , 23 ].…”

Haematological indices as predictors of atrial fibrillation following isolated coronary artery bypass grafting, valvular surgery, or combined procedures: a systematic review with meta-analysis

“…(3) study design (case-control vs. cohort); (4) sample size (≤ 200 vs. > 200); (5) mean age (≤ 60 vs. > 60 years); (6) percentage of men (≤ 70% vs. > 70%); (7) history of diabetes (≤ 30% vs. > 30%); (8) history of hypertension (≤ 70% vs. > 70%); (9) cigarette smoking (≤ 30% vs. > 30%); (10) history of myocardial infarction (≤ 20% vs. > 20%); (11) preoperative left ventricular ejection fraction (≤ 50% vs. > 50%); (12) preoperative use of drugs such as beta-blockers, statins, diuretics, angiotensin converting enzyme inhibitors, or angiotensin receptor blockers (for each: ≤ 70% vs. > 70%); (13) type of surgery (isolated CABG, isolated valvular surgery, combined procedures); (14) method of surgery (on-pump, off-pump); (15) status of surgery (elective, non-elective), (16) cross-clamp time (≤ 60 min vs. > 60 min); and (17) cardiopulmonary bypass time (≤ 100 min vs. > 100 min).…”

Izole Off-Pump Koroner Arter Bypass Sonrasi Yeni Baslangicli Atrial Fibrilasyon Gelisiminde Preoperatif D Vitaminin Etkisi var midir?

“…Klasik olarak bahsedebileceğimiz bu risk faktörlerinin yanında, özellikle AF'nin patofizyolojisinde inflamasyonun rolü ile ilgili yeni risk faktörleri speküle edilmiştir (13,14). Örneğin litaratürde ameliyat öncesi ortalama trombosit hacmi ve C-reaktif protein seviyeleri, ameliyat sonrası atriyal fibrilasyonun gelişimi ile ilişkili olduğu bildirilmiştir (15). Aviles ve ark.…”