Postoperative White Blood Cell Count Predicts Atrial Fibrillation after Cardiac Surgery

Lamm, Gudrun; Auer, Johann; Weber, Thomas; Baldassano, Robert N.; Ng, C K; Eber, Bernd

doi:10.1016/j.eupc.2005.08.001

Cited by 22 publications

(31 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Twenty‐one cohort studies evaluated the association between systemic inflammation measured by serum inflammatory biomarkers and PNAF (Tables and ) .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Inflammation in new‐onset atrial fibrillation after cardiac surgery: a systematic review

Jacob

Nathoe

Dieleman

et al. 2014

Eur J Clin Investigation

View full text Add to dashboard Cite

Background Postoperative new-onset atrial fibrillation (PNAF) is the most common complication following cardiac surgery. The pathogenesis of PNAF is multifactorial. The concept of the postoperative inflammatory response, as a potential underlying mechanism has been extensively studied. This review aims to provide a comprehensive summary of literature relevant to the association between the inflammatory response following cardiac surgery and PNAF.

show abstract

“…Twenty‐one cohort studies evaluated the association between systemic inflammation measured by serum inflammatory biomarkers and PNAF (Tables and ) .…”

Section: Resultsmentioning

confidence: 99%

“…Four studies with 594 participants investigated the association between high levels of white blood cell count (WBC) and PNAF. All four studies showed that high levels of WBC predicted PNAF [6,[20][21][22]. This predictive value is greater when the neutrophil/lymphocyte ratio is elevated (Gibson et al [20]).…”

Section: Inflammatory Biological Markersmentioning

confidence: 99%

Inflammation in new‐onset atrial fibrillation after cardiac surgery: a systematic review

Jacob

Nathoe

Dieleman

et al. 2014

Eur J Clin Investigation

View full text Add to dashboard Cite

show abstract

“…Leukocytes are inflammatory cells that may regulate oxidative stress by releasing reactive oxygen species . They have been shown to be increased after cardiac surgery and may predict POAF . In a very recent study, Rodrigo et al randomized the patients undergoing cardiac surgery to n‐3 polyunsaturated fatty acids, vitamin C, and vitamin E or placebo, and found that POAF rate and postoperative biomarkers of inflammation and oxidative stress were lower in the intervention group as compared with the placebo group …”

Section: Discussionmentioning

confidence: 99%

Oxidative Status, Inflammation, and Postoperative Atrial Fibrillation With Metoprolol vs Carvedilol or Carvedilol Plus N‐Acetyl Cysteine Treatment

Özaydın

Peker

Erdoğan

et al. 2014

Clinical Cardiology

View full text Add to dashboard Cite

Background: Atrial fibrillation is associated with inflammation and oxidative stress. Hypothesis: Carvedilol and N-acetyl cysteine (NAC) combination decreases inflammation, oxidative stress, and postoperative atrial fibrillation (POAF) rates more than metoprolol or carvedilol. Methods: Preoperative and postoperative total oxidative stress (TOS), total antioxidant capacity (TAC), and white blood cells (WBC) were measured in metoprolol, carvedilol, or carvedilol plus NAC groups, and association with POAF was evaluated. Results: Preoperative TAC, TOS, and WBC levels were similar among the groups. Postoperative TAC levels were lower in the metoprolol group compared with the carvedilol group (1.0 vs 1.4) or the carvedilol plus NAC group (1.0 vs 1.9) and were also lower in the carvedilol group compared with the carvedilol plus NAC group (all P < 0.0001). Postoperative TOS levels were higher in the metoprolol group as compared with the carvedilol (29.6 vs 24.2; P < 0.0001) or the carvedilol plus NAC groups (P < 0.0001), and were also higher in the carvedilol group as compared with the carvedilol plus NAC group (24.2 vs 19.3; P < 0.0001). Postoperative WBC counts were lower in the carvedilol plus NAC group compared with the metoprolol group (12.9 vs 14.8; P = 0.004), were similar between the carvedilol and the metoprolol groups (13 vs 14.8) and between the carvedilol plus NAC group and the carvedilol group (both P > 0.05). Postoperative TAC, TOS, and WBC were associated with POAF. Conclusions: Carvedilol plus NAC reduced oxidative stress and inflammation compared with metoprolol and decreased oxidative stress compared with carvedilol. Postoperative TAC, TOS, and WBC were associated with POAF. IntroductionCardiopulmonary bypass may cause oxidative stress and inflammation 1 processes that have been shown to be associated with atrial fibrillation.2 -5 Carvedilol is a nonselective β-blocker and N-acetyl cysteine (NAC) is a mucolytic agent. These agents have anti-inflammatory and antioxidant properties, 6 -16 and they decreased postoperative atrial fibrillation (POAF) rates in previous studies.2,17 -22 In a randomized study, we have shown that carvedilol plus NAC decreased POAF incidence compared with metoprolol or carvedilol.23 However, it is not known whether the effect of carvedilol and NAC is associated with changes in the levels of oxidative markers or whether there is a correlation between these markers and the development of POAF.

show abstract

“…19 Two recent studies demonstrated that leukocytosis, a frequent finding early after cardiopulmonary bypass, is an independent predictor of postoperative AF after cardiac surgery. 20,21 The anti-inflammatory properties of ivabradine might play a role in achieving the beneficial effect of the drug (added to a βblocker) in preventing AF following cardiac surgery. Further studies are necessary to elucidate the exact mechanism by which ivabradine, added to β-blockers, reduces incident AF in such setting.…”

Section: Prevention Of Postoperative Af With Ivabradinementioning

confidence: 99%

“…Moreover, we excluded patients with left ventricular systolic dysfunction; our results cannot be extrapolated to this patient subset. Additionally, due to logistic and financial limitations, rhythm monitoring with loop recorders was used for only 15 postoperative days, and the patients had no continuous rhythm monitoring in postoperative days [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]; rhythm follow-up during that period was performed by weekly clinical follow-up visits. Therefore, some episodes of silent AF might have been missed during this period; this might have caused underestimation of the incidence of postoperative AF.…”

Section: Limitationsmentioning

confidence: 99%

Atrial Fibrillation After Coronary Artery Bypass Surgery: Can Ivabradine Reduce Its Occurrence?

Abdel-Salam

Nammas

2016

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

Postoperative White Blood Cell Count Predicts Atrial Fibrillation after Cardiac Surgery

Cited by 22 publications

References 0 publications

Inflammation in new‐onset atrial fibrillation after cardiac surgery: a systematic review

Inflammation in new‐onset atrial fibrillation after cardiac surgery: a systematic review

Oxidative Status, Inflammation, and Postoperative Atrial Fibrillation With Metoprolol vs Carvedilol or Carvedilol Plus N‐Acetyl Cysteine Treatment

Atrial Fibrillation After Coronary Artery Bypass Surgery: Can Ivabradine Reduce Its Occurrence?

Contact Info

Product

Resources

About