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C-reactive protein is a risk indicator for atrial fibrillation after myocardial revascularization

Bernard Lo1, Rob Fijnheer, Arno P Nierich

  • 1Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands. b.lo@azu.nl

The Annals of Thoracic Surgery
|April 28, 2005
PubMed

Insights

High baseline C-reactive protein (CRP) levels indicate a greater risk for postoperative atrial fibrillation (AF) after coronary artery bypass graft surgery. This risk applies to both on-pump and off-pump procedures.

Area of Science:

  • Cardiology
  • Inflammation Research
  • Surgical Outcomes

Background:

  • Coronary artery bypass graft (CABG) surgery activates the complement system, involving C-reactive protein (CRP).
  • Elevated baseline CRP levels correlate with increased risk of postoperative atrial fibrillation (AF).
  • The study examines if baseline CRP predicts AF and if cardiopulmonary bypass influences this association.

Purpose of the Study:

  • To determine if baseline C-reactive protein (CRP) levels predict the occurrence of postoperative atrial fibrillation (AF).
  • To assess whether the association between CRP and AF is dependent on the use of cardiopulmonary bypass during CABG surgery.

Main Methods:

  • Measured perioperative C-reactive protein (CRP) in patients undergoing CABG surgery, with or without cardiopulmonary bypass (Octopus Study).
  • Categorized baseline CRP into low (<3.0 mg/L) and high (≥3.0 mg/L) groups.
  • Analyzed AF incidence based on baseline CRP levels and surgical method (on-pump vs. off-pump).

Main Results:

  • In on-pump CABG, high baseline CRP was linked to significantly higher AF rates (55%) compared to low CRP (21%, p=0.01).
  • In off-pump CABG, high baseline CRP also showed a higher AF incidence (30%) versus low CRP (8%, p=0.002).
  • Adjusted analysis confirmed baseline CRP as an independent predictor of AF across both surgical groups (OR=3.3, p=0.02).

Conclusions:

  • Elevated baseline C-reactive protein (CRP) levels are a significant risk factor for developing postoperative atrial fibrillation (AF).
  • This increased risk associated with high CRP is evident regardless of whether cardiopulmonary bypass is used during coronary artery bypass graft surgery.
Abstract

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