Relation of inflammatory cytokines to atrial fibrillation after off-pump coronary artery bypass grafting

Ishida, Keiichi; Kimura, Fumio; Imamaki, Mizuho; Ishida, Atsushi; Shimura, Hitoshi; Kohno, Hiroki; Sakurai, Makoto; Miyazaki, Masaru

doi:10.1016/j.ejcts.2005.12.028

Cited by 117 publications

(90 citation statements)

References 24 publications

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“…9,10) CRP can be used to measure systemic inflammation in clinical settings. 8,11,12) In this study, the postoperative mean peak CRP level was higher in patients who developed postoperative atrial fibrillation (168.3 ± 29.1 mg/L versus 112.6 ± 19.6 mg/L in patients without atrial fibrillation, P < 0.0001), and logistic regression analysis showed postoperative CRP levels above the median value were associated with increased risk of postoperative atrial fibrillation (2.421, P = 0.015). This study further confirmed the importance of inflammation in the development of atrial fibrillation following CCABG.…”

Section: Discussionmentioning

confidence: 48%

Role of Preoperative Atorvastatin Administration in Protection Against Postoperative Atrial Fibrillation Following Conventional Coronary Artery Bypass Grafting

Sun

Mei

et al. 2011

Int. Heart J.

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SummaryAtrial fibrillation (AF) is one of the most common postoperative arrhythmias in patients who undergo coronary artery bypass grafting (CABG). The aim of this study was to evaluate the effect of preoperative atorvastatin on postoperative atrial fibrillation following coronary artery bypass grafting with cardiopulmonary bypass (CCABG). One hundred consecutive patients undergoing elective CCABG, without history of AF or previous statin treatment, were enrolled and randomly assigned to a statin group (atorvastatin 20 mg/d, n = 49) or a control group (placebo, n = 51) starting 7 days preoperatively. The primary endpoint was the occurrence of postoperative AF. C-reactive protein (CRP) levels were assessed in all selected patients before surgery and every 24 hours postoperatively until discharge from hospital. Atorvastatin significantly reduced the incidence of postoperative AF and postoperative peak CRP level versus placebo (18% versus 41%, P = 0.017; 129.3 ± 24.3 mg/L versus 149.3 ± 32.5 mg/L, P < 0.0001). Kaplan-Meier curves confirmed a significantly better postoperative atrial fibrillation-free survival in the statin group (χ 2 = 7.466, P = 0.006). Logistic regression analysis showed preoperative atorvastatin treatment was an independent factor associated with a significant reduction in postoperative AF (OR = 0.235, P = 0.007), whereas high postoperative CRP levels were associated with increased risk (OR = 2.421, P = 0.015). Preoperative atorvastatin administration may inhibit inflammatory reactions to prevent atrial fibrillation following coronary artery bypass grafting with cardiopulmonary bypass. (Int Heart J 2011; 52: 7-11) Key words: Coronary artery bypass grafting, Cardiopulmonary bypass, Atorvastatin, Atrial fibrillation A trial fibrillation (AF) is one of the most important complications after coronary artery bypass grafting (CABG) and has an incidence of approximately 30%.1,2) Atrial fibrillation can severely influence hemodynamic stability; it can induce loss of atrial pump function resulting in impairment of ventricular filling with a decrease in cardiac output and an increase in incidence of stroke, thus contributing to the rise of postoperative disability and mortality.3) For patients with atrial fibrillation, especially in those after CABG, a rapid ventricular rate significantly increases myocardial oxygen consumption, induces cardiac insufficiency, and aggravates myocardial ischemia; it can even lead to tachycardiomyopathy, which can severely threaten the life of the patient. Therefore, it is very important to prevent atrial fibrillation following CABG. Recent studies found that atrial fibrillation after CABG may be associated with inflammatory response, and statins have been shown to inhibit such inflammatory response, and reduce the incidence of AF after CABG. [4][5][6][7][8] Nevertheless, since atrial fibrillation has a significant genetic heterogeneity and the effects of the drugs used to treat the latter are different among different races, exploring the effects of statins on postoperative...

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Section: Discussionmentioning

confidence: 48%

Role of Preoperative Atorvastatin Administration in Protection Against Postoperative Atrial Fibrillation Following Conventional Coronary Artery Bypass Grafting

Sun

Mei

et al. 2011

Int. Heart J.

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“…Ishida, et al 50) examined the relationship between proinflammatory cytokines, which play an important role in the upstream regulation of inflammatory cascades, and the development of AF after OPCAB in a 39 patients' case series. Eleven patients (28%) developed AF postoperatively.…”

Section: Postoperative Atrial Fibrillation (Af)mentioning

confidence: 99%

Off-Pump Coronary Artery Bypass Grafting Revisited: Experience and Evidence from Japan

Doi

Okawa

2013

ATCS

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Off-pump coronary artery bypass grafting (OPCAB) is performed in about 65% of patients who require surgical coronary revascularization, and has become the standard procedure in coronary artery bypass grafting (CABG) in Japan. As a background of the high rate of OPCAB, many clinical and experimental studies have been performed and reported in Japan. In this review, several factors associated with OPCAB are discussed based on relevant and important clinical studies published in Japan in the English language.

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“…Considering inflammatory processes involved in postoperative AF, the markers of inflammation may be of importance in diagnosing and/or risk stratification of such patients. Accordingly, Ishida et al [22] have noted that C-reactive protein (CRP), interleukin-6 (IL-6) and IL-8 increased after off-pump CABG surgery, but IL-6 was only significantly different between patients with and without postoperative AF, and it was an independent predictor of postoperative AF occurrence. 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].…”

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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Relation of inflammatory cytokines to atrial fibrillation after off-pump coronary artery bypass grafting

Abstract: Advanced age was a major risk factor for postoperative AF. Furthermore, inflammatory response induced by surgical trauma was also associated with the development of AF after off-pump CABG.

Cited by 117 publications

References 24 publications

Role of Preoperative Atorvastatin Administration in Protection Against Postoperative Atrial Fibrillation Following Conventional Coronary Artery Bypass Grafting

Role of Preoperative Atorvastatin Administration in Protection Against Postoperative Atrial Fibrillation Following Conventional Coronary Artery Bypass Grafting

Off-Pump Coronary Artery Bypass Grafting Revisited: Experience and Evidence from Japan

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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