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Plasma Catecholamine Levels on the Morning of Surgery Predict Post-Operative Atrial Fibrillation.

Ethan J Anderson1,2, Jimmy T Efird3,4,5,6, Andy C Kiser4

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Pre-operative plasma catecholamines, specifically norepinephrine and epinephrine, are linked to increased risk of post-operative atrial fibrillation (POAF). Assessing these adrenergic markers may help predict POAF in cardiac surgery patients.

Keywords:
catecholamineheart surgerypost-operative atrial fibrillationsympathetic activation

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Area of Science:

  • Cardiology
  • Biochemistry

Background:

  • Intra- and post-operative adrenergic tone is implicated in post-operative atrial fibrillation (POAF).
  • The role of pre-operative plasma catecholamines in POAF remains unclear.

Purpose of the Study:

  • To investigate the association between pre-operative plasma catecholamines and monoamine oxidase-B (MOA-B) with POAF in patients undergoing elective cardiac surgery.

Main Methods:

  • Blood samples from 324 cardiac surgery patients were analyzed for norepinephrine (NE), dopamine (DA), epinephrine (EPI), and MAO-B concentrations.
  • Log-binomial regression modeled the association between catecholamine/MAO-B quartiles and POAF incidence.

Main Results:

  • Higher levels of NE and EPI were positively associated with POAF.
  • Higher DA levels showed an inverse association with POAF.
  • A composite pre-operative adrenergic marker significantly increased POAF occurrence (adjusted p = 0.0001); MAO-B showed no association.

Conclusions:

  • Pre-operative adrenergic tone, indicated by plasma catecholamines, is a significant factor in POAF development.
  • Plasma catecholamine assessment offers a potentially low-cost method for POAF risk prediction.
  • Further multicentric studies are needed to validate these findings.