Key result
LA diameter >41mm and altered oxidative stress are linked to ~310% higher POAF risk after CABG.
Why the study?
The association of clinical, echocardiographic parameters, and oxidative stress markers with postoperative atrial fibrillation in patients undergoing CABG required estimation.
Case-Control (n=158)
Odds Ratio: 4.1 (95% CI 1.7–8.9)
p-value: p=0.001
Increased left atrial diameter and markers of high oxidative stress and low antioxidant activity are significantly associated with the development of postoperative atrial fibrillation after CABG.
May support preoperative AF risk stratification after CABG; hypothesis-generating, requires prospective validation before practice change.
Aim. To estimate the association of clinical, echocardiographic parameters and markers of oxidative stress with postoperative atrial fibrillation (POAF) in patients with coronary artery disease (CAD) undergoing coronary artery bypass graft (CABG) surgery. Material and methods . This case-control study included 158 patients with CAD who were scheduled for CABG surgery. Patients were divided into two groups: group 1 (n=111) — patients without POAF (men — 82%, median age — 62,0 [56,0;66,0] years); group 2 (n=47) — patients with POAF (men — 84,4%, median age — 65,0 [61,0;70,0] years). The median of POAF development was 5,2 [2,0;7,0] days after CABG. We studied plasma and erythrocyte superoxide dismutase (SOD) levels, plasma nitrogen oxide and myeloperoxidase levels, erythrocyte levels of catalase, malondialdehyde, reduced glutathione, glutathione reductase and glutathione peroxidase, and advanced oxidation protein products. The determination was carried out before and on average 3-4 days after CABG. All the patients also underwent echocardiography. Results. Multivariate regression revealed following parameters associated with POAF: left atrial diameter >41 mm (odds ratio (OR) 4,1,95% confidence interval (CI) 1,7-8,9, р=0,001), postoperative plasma levels of SOD >1100,5 U/g (OR 3,0, 95% CI 1,3-9,7, р=0,04), postoperative levels of reduced glutathione <0,194 Mmol/g Hb (OR 1,6, 95% CI 1,1-6,8, р=0,002), postoperative levels of glutathione peroxidase <17,36 mmol/g Hb (OR 1,9, 95% CI 1,1-7,8, р=0,0005), postoperative levels of glutathione reductase <2,99 mmol/g Hb (OR 2,1, 95% CI, 1,1-5,9, р=0,004), postoperative levels of malondialdehyde >1,25 Mmol/g Hb (OR 1,9, 95% CI 1,1-7,2, р<0,0001), postoperative plasma levels of nitrogen oxide >36,4 Mmol/l (OR 1,4, 95% CI 1,03-4,8, р=0,001). Conclusion. Our study showed significant association of increased left atrial diameter, high activity of oxidative stress and low activity of antioxidant system with POAF in patients with CAD undergoing CABG surgery.
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Рубаненко et al. (2020) conducted a case-control in Coronary artery disease undergoing CABG surgery (n=158). Left atrial diameter >41 mm and oxidative stress markers vs. Absence of these risk factors was evaluated on Postoperative atrial fibrillation (POAF) (OR 4.1, 95% CI 1.7-8.9, p=0.001). Left atrial diameter >41 mm (OR 4.1; 95% CI 1.7-8.9; p=0.001) and altered oxidative stress markers were significantly associated with postoperative atrial fibrillation after CABG surgery.
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