BACKGROUND: Activation of the complement system after coronary artery bypass graft surgery involves C-reactive protein (CRP). This inflammatory response is related to baseline CRP levels and associated with postoperative arrhythmia, in particular atrial fibrillation (AF). We investigated whether baseline CRP levels are a risk indicator for the occurrence of AF and whether this phenomenon is cardiopulmonary bypass dependent. METHODS: C-reactive protein was measured in perioperative blood samples of patients of the Octopus Study (coronary artery bypass graft surgery with [n = 73] or without cardiopulmonary bypass [n = 79]). Baseline CRP was dichotomized into a low and a high baseline group, using a cutoff value of 3.0 mg/L. RESULTS: After coronary artery bypass graft surgery with cardiopulmonary bypass 11 of 53 patients (21%) with low preoperative CRP levels had AF versus 11 of 20 patients (55%) with high baseline CRP levels (p = 0.01). In the off-pump group AF occurred in 4 of 52 patients (8%) who had low baseline CRP levels, versus 8 of 27 patients (30%) with high preoperative CRP levels (p = 0.002). After adjusting for age, the odds ratio (95% confidence interval) was 4.6 (1.4 to 15.3) with cardiopulmonary bypass, 3.7 (0.93 to 14.7) in the off-pump group, and 3.3 (1.4 to 7.6) for both groups together. Continuous baseline CRP was an independent predictor for AF in a multivariate logistic regression model (p = 0.02). CONCLUSIONS: Patients with high baseline CRP levels are at higher risk of having postoperative AF in both on-pump and off-pump surgery.
BACKGROUND: Activation of the complement system after coronary artery bypass graft surgery involves C-reactive protein (CRP). This inflammatory response is related to baseline CRP levels and associated with postoperative arrhythmia, in particular atrial fibrillation (AF). We investigated whether baseline CRP levels are a risk indicator for the occurrence of AF and whether this phenomenon is cardiopulmonary bypass dependent. METHODS:C-reactive protein was measured in perioperative blood samples of patients of the Octopus Study (coronary artery bypass graft surgery with [n = 73] or without cardiopulmonary bypass [n = 79]). Baseline CRP was dichotomized into a low and a high baseline group, using a cutoff value of 3.0 mg/L. RESULTS: After coronary artery bypass graft surgery with cardiopulmonary bypass 11 of 53 patients (21%) with low preoperative CRP levels had AF versus 11 of 20 patients (55%) with high baseline CRP levels (p = 0.01). In the off-pump group AF occurred in 4 of 52 patients (8%) who had low baseline CRP levels, versus 8 of 27 patients (30%) with high preoperative CRP levels (p = 0.002). After adjusting for age, the odds ratio (95% confidence interval) was 4.6 (1.4 to 15.3) with cardiopulmonary bypass, 3.7 (0.93 to 14.7) in the off-pump group, and 3.3 (1.4 to 7.6) for both groups together. Continuous baseline CRP was an independent predictor for AF in a multivariate logistic regression model (p = 0.02). CONCLUSIONS:Patients with high baseline CRP levels are at higher risk of having postoperative AF in both on-pump and off-pump surgery.
Authors: David Conen; Paul M Ridker; Brendan M Everett; Usha B Tedrow; Lynda Rose; Nancy R Cook; Julie E Buring; Christine M Albert Journal: Eur Heart J Date: 2010-05-25 Impact factor: 29.983
Authors: Charles W Hogue; Christopher A Palin; Rajagopal Kailasam; Jennifer S Lawton; Abdullah Nassief; Victor G Dávila-Román; Betsy Thomas; Ralph Damiano Journal: Ann Thorac Surg Date: 2006-07 Impact factor: 4.330
Authors: Hasan Gungor; Abraham Samuel Babu; Cemil Zencir; Mahmut Akpek; Mithat Selvi; Muhammet Huseyin Erkan; Selim Durmaz Journal: Med Princ Pract Date: 2016-11-21 Impact factor: 1.927
Authors: Bernard Panaszek; Ewa Liebhart; Jerzy Liebhart; Robert Pawłowicz; Andrzej M Fal Journal: Arch Immunol Ther Exp (Warsz) Date: 2007 Sep-Oct Impact factor: 4.291