Increased Preoperative White Blood Cell Count Predicts Postoperative Atrial Fibrillation After Coronary Artery Bypass Surgery

Fontes, Manuel L.; Amar, David; Kulak, Amy; Koval, K.; Zhang, Hao; Shi, Wei; Thaler, Howard T.

doi:10.1053/j.jvca.2009.01.030

Cited by 44 publications

(33 citation statements)

References 23 publications

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“…This is largely based on association between levels and activity of white blood cells and incidence of POAF. Patients who have higher postoperative leukocytes count are significantly more likely to develop POAF (Abdelhadi, Gurm, Van Wagoner, & Chung, 2004;Fontes, et al, 2009;Lamm, et al, 2006;Sabol, et al, 2012) and patients developing POAF tend to have greater degree of monocyte activation as seen by higher expression of CD11b (Fontes, et al, 2005). Moreover; the elevated pre and postoperative neutrophils/ lymphocytes ratio in patients undergoing CABG can be associated with an increased incidence of POAF (Gibson, et al, 2010).…”

Section: Inflammatory Response and Factors That Alter Incidence Of Poafmentioning

confidence: 99%

Inflammation, oxidative stress and postoperative atrial fibrillation in cardiac surgery

Zakkar

Ascione

James

et al. 2015

Pharmacology & Therapeutics

189

129

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Postoperative atrial fibrillation (POAF) is a common complication of cardiac surgery that occurs in up to 60% of patients. POAF is associated with increased risk of cardiovascular mortality, stroke and other arrhythmias that can impact on early and long term clinical outcomes and health economics. Many factors such as disease-induced cardiac remodelling, operative trauma, changes in atrial pressure and chemical stimulation and reflex sympathetic/parasympathetic activation have been implicated in the development of POAF. There is mounting evidence to support a major role for inflammation and oxidative stress in the pathogenesis of POAF. Both are consequences of using cardiopulmonary bypass and reperfusion following ischaemic cardioplegic arrest. Subsequently, several anti-inflammatory and antioxidant drugs have been tested in an attempt to reduce the incidence of POAF. However, prevention remains suboptimal and thus far none of the tested drugs has provided sufficient efficacy to be widely introduced in clinical practice. A better understanding of the cellular and molecular mechanisms responsible for the onset and persistence of POAF is needed to develop more effective prediction and interventions.

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Section: Inflammatory Response and Factors That Alter Incidence Of Poafmentioning

confidence: 99%

Inflammation, oxidative stress and postoperative atrial fibrillation in cardiac surgery

Zakkar

Ascione

James

et al. 2015

Pharmacology & Therapeutics

189

129

View full text Add to dashboard Cite

show abstract

“…To date, the relations between WBC count and atrial fibrillation (AF) have not been extensively explored. Increased WBC count during the perioperative period was predictive of post-operative AF, 1-4 and a small observational study observed that increased WBC count was associated with recurrence of AF post-pulmonary vein isolation. 5 However, whether increased WBC count is associated with AF in the general population is unclear.…”

mentioning

confidence: 96%

White Blood Cell Count and Risk of Incident Atrial Fibrillation (From the Framingham Heart Study)

Rienstra¹,

Sun²,

Magnani³

et al. 2012

The American Journal of Cardiology

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Several studies have reported that inflammatory markers are associated with atrial fibrillation (AF). White blood cell (WBC) count is a widely available and broadly utilized marker of systemic inflammation. We sought to investigate the association between increased WBC count and incident AF, and whether this association is mediated by smoking, myocardial infarction and heart failure. We examined participants in the Framingham Heart Study Original Cohort. Cox proportional hazard regression analysis was used to examine the relation between WBC count and incident AF over 5-year follow-up period. We adjusted for standard AF risk factors, and smoking, previous myocardial infarction, as well as interim myocardial infarction and heart failure prior to incident AF. Our sample consisted of 936 participants, mean age was 76±6 years and 61% were women. Median WBC count was 6.4*109/L (25th-75th percentile 5.6*109/L- 7.8*109/L). During a median follow-up of 5 years, 82 participants (9%) developed new-onset AF. After adjusting for standard risk factors for AF, increased WBC count was significantly associated with incident AF, with a hazard ratio per standard deviation (0.26*109/L) increase of 2.22, (95% confidence interval, 1.10–4.48; P=0.03). We found no substantive differences adjusting for smoking, previous myocardial infarction, interim myocardial infarction and heart failure. In conclusion, in our community-based sample, increased WBC count was associated with incident AF during 5-years of follow-up. Our findings provide additional evidence for the relation between systemic inflammation and AF.

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“…Patients with an increased baseline CRP value have also been found to be in higher risk for developing AF after on-and off-pump CABG surgery [23]. White blood cell count is another marker that has been investigated and both pre-and post-operative increased values were the independent predictors of AF incidence following cardiac surgery [24,25]. ESR is an inexpensive marker for acute phase response accompanied with diagnostic and prognostic values, especially in the rheumatic diseases and newly found non-inflammatory conditions such as stork and coronary artery disease [26,27].…”

Section: Discussionmentioning

confidence: 99%

Effect of oral vitamin C on atrial fibrillation development after isolated coronary artery bypass grafting surgery: A prospective randomized clinical trial

et al. 2014

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C and control groups, respectively (p = 0.002). The hospital stay was significantly lower in vitamin C group compared with that of the control group (5.32 ± 0.59 vs. 5.74 ± 1.30 days, respectively, p = 0.041). Baseline erythrocyte sedimentation rate (OR 1.030, p = 0.030) and taking vitamin C (OR 8.068, p = 0.007) were the independent predictors of postoperative AF. Conclusions: Oral vitamin C can be safely used to decrease the incidence of postoperative AF in patients undergoing elective isolated on-pump CABG surgery. (Cardiol J 2014; 21, 5: 492-499)

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Increased Preoperative White Blood Cell Count Predicts Postoperative Atrial Fibrillation After Coronary Artery Bypass Surgery

Cited by 44 publications

References 23 publications

Inflammation, oxidative stress and postoperative atrial fibrillation in cardiac surgery

Inflammation, oxidative stress and postoperative atrial fibrillation in cardiac surgery

White Blood Cell Count and Risk of Incident Atrial Fibrillation (From the Framingham Heart Study)

Effect of oral vitamin C on atrial fibrillation development after isolated coronary artery bypass grafting surgery: A prospective randomized clinical trial

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