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Comprehensive Analysis of Factors Associated with New Episode of Postoperative Atrial Fibrillation after Coronary

Olesya Rubanenko1, Anatoly Rubanenko2, Igor Davydkin1

  • 1Hospital Therapy Department, Samara State Medical University, 89, Chapaevskaya St., 443099 Samara, Russia.

Life (Basel, Switzerland)
|October 28, 2023
PubMed

Insights

Postoperative atrial fibrillation (POAF) after coronary artery bypass graft (CABG) surgery is linked to increased left atrial diameter, inflammation, oxidative stress, fibrosis, and a low omega-3 index. These factors are key indicators for predicting POAF risk in cardiac patients.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Electrophysiology
  • Biochemistry and Molecular Biology

Background:

  • Postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass graft (CABG) surgery.
  • Understanding the underlying factors contributing to POAF is crucial for risk stratification and prevention strategies in patients with coronary artery disease.

Purpose of the Study:

  • To conduct a comprehensive analysis of factors including inflammation, oxidative stress, fibrosis, myocardial dysfunction, ischemia, and omega-3 index associated with POAF post-CABG.
  • To identify key predictors of POAF in patients undergoing CABG surgery.

Main Methods:

  • A cohort of 158 patients undergoing CABG surgery was studied, divided into groups with and without POAF.
  • Laboratory tests (inflammatory markers, oxidative stress indicators, glutathione levels) and echocardiography were performed before and after surgery.
  • Multifactorial regression analysis was used to determine the odds ratios for various factors associated with POAF development.

Main Results:

  • Significant associations were found between POAF and increased left atrial diameter (>41 mm), elevated postoperative levels of interleukin-6 (>22.07 pg/mL) and interleukin-8 (>9.67 pg/mL).
  • Increased oxidative stress markers, including superoxide dismutase (>1100.5 U/g) and malondialdehyde (>1.25 µmol/g hemoglobin), and altered glutathione metabolism were linked to POAF.
  • Lower omega-3 index (≤1.59%) and specific thresholds for nitric oxide (NO) levels (>36.4 µmol/L) were also identified as risk factors for POAF.

Conclusions:

  • Elevated left atrial diameter, heightened postoperative inflammation, and markers of oxidative stress and fibrosis are significantly associated with the occurrence of POAF after CABG.
  • A lower omega-3 index is also a notable risk factor for POAF in this patient population.
  • These findings highlight the multifactorial nature of POAF and suggest potential targets for therapeutic interventions and risk management.

Keywords:
atrial fibrillationcoronary artery bypass graftfibrosisinflammationmyocardial dysfunctionmyocardial ischemiaomega-3 indexoxidative stress

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