Perioperative serum troponin I levels are associated with higher risk for atrial fibrillation in patients undergoing coronary artery bypass graft surgery

Abstract

Atrial fibrillation (AF) remains a frequent complication after coronary artery bypass graft surgery (CABG). We evaluate the association of AF occurrence and serum cardiac troponin I (cTnI) levels in the early postoperative period after CABG. Between April 2009 and January 2010, 95 consecutive patients with sinus rhythm who underwent CABG were evaluated. The patients were divided into two groups according to their postoperative rhythms: sinus rhythm group (SR) and AF group (AF). Demographic, clinical variables, and troponin I were evaluated at the pre- and postoperative times. There were no clinical or demographic differences between the two groups. The postoperative troponin I in the SR group was lower than that in the AF group (0.66 ± 1.62 vs. 2.07 ± 5.01 ng/ml; P = 0.029). Using the receiver operating characteristic curves was found as the best cut-off value to predict AF occurrence at the value of 0.901 ng/ml. Using this value of cTnI, a sensitivity of 60% and a specificity of 87% for AF onset prediction were observed. The cTnI serum levels at the postoperative period after CABG were higher in patients who subsequently developed AF. The cut-off value of 0.901 ng/ml is useful for prediction and preventive therapeutic actions.

Usefulness of troponin I for prediction of atrial fibrillation after coronary artery bypass grafting

“…Although we found no association between cTnI and postoperative AF and did not detect a cut-off value of cTnI which was able to distinguish the patients at high-risk for AF occurrence, Leal et al [14] included 95 patients who exclusively underwent CABG showed that postoperative cTnI levels were associated with the AF occurrence after CABG. The authors also found a cut-off value of 0.901 ng/ mL of cTnI after surgery, which was able to identify high-risk patients for postoperative AF.…”

“…[12,13] The pathogenesis of postoperative AF is multifactorial and includes preoperative, perioperative, and postoperative factors such as gender, age, hypertension, DM, hyperlipidemia, chronic renal failure, ejection fraction, number of grafts performed, left atrial enlargement, acute atrial dilatation, atrial injury caused by cannulation, RCA stenosis, CPB run length, cross-clamping time, electrolyte imbalance, and pericarditis. [2,5,[14][15][16][17] However, in this study, we found no association between these variables and postoperative AF development. Among these factors, age was documented to be the most reliable predictor for postoperative AF.…”

“…Also, there are other studies showing no relationship between postoperative AF in patients undergoing CABG and gender, DM, hypertension, and hypercholesterolemia. [17,18] Furthermore, Leal et al [14] found no association between postoperative AF and age, gender, ejection fraction, left atrial dimension, the number of grafts with the exception of CPB run length and cross-clamping time. Similarly, Koletsis et al [1] and Sezai Hata et al [2] did not found any relation between postoperative AF and CPB run length and cross-clamping time in patients undergoing CABG.…”

Relation between soluble ST2, growth differentiation factor–15, and high-sensitivity troponin I and incident atrial fibrillation

“…To date, contradictory results have been published regarding the value of elevated TnI levels to predict AF in the post-operative setting after coronary artery bypass graft surgery. 34 There have been few reports on the predictive utility of hsTnI for AF in community- or hospital-based settings. One small community-based Japanese study including 220 residents without apparent cardiovascular disease reported that hsTnT concentrations were higher in the 12 (6%) patients with AF at health checkup examination than in those without AF.…”

Levosimendan Use Decreases Atrial Fibrillation in Patients after Coronary Artery Bypass Grafting: A Pilot Study

“…As we known that cardiac troponin displayed powerful prognostic properties in patients with AF, with almost a 2-fold increase of stroke risk and more than a 3-fold increase of cardiovascular mortality when AF patients had elevated versus undetectable levels were compared. Leal et al have shown that the higher cTnI serum levels were detected in patients who developed AF at the postoperative period after CABG [Leal 2012]. Thus, when we detected high cardiac biomarkers such as cardiac TnI and CK-MB after CABG, we followed the patients for a long time after discharge from the hospital.…”