ISSN 2996-8215
International Journal of Cardiology | Vol. 1, No. 6, June 2010 | pp. 41–48
DOI: 10.46882/2010/IJC/000015
Original Research Article
Association Between High-Sensitivity C-Reactive Protein and Incidence of Atrial Fibrillation Post-Cardiac Surgery
Alexander Wright¹, Chloe Jenkins¹, Marcus Vance²
¹School of Medicine, University of Sydney, Sydney, New South Wales, Australia
²Department of Cardiology, Green Lane Cardiovascular Service, Auckland, New Zealand
Abstract:
Postoperative atrial fibrillation (POAF) is a frequent complication following cardiac surgery, associated with prolonged hospital stay and increased risk of stroke. Inflammation is hypothesized to play a crucial role in the pathogenesis of POAF. This prospective observational study investigated the association between preoperative and early postoperative high-sensitivity C-reactive protein (hs-CRP) levels and the development of POAF. We enrolled 310 sinus rhythm patients undergoing coronary artery bypass grafting (CABG) or valvular surgery. Continuous telemetry monitored cardiac rhythm during the first 7 postoperative days. Blood samples for hs-CRP were collected 24 hours preoperatively and on postoperative days 1, 3, and 5. POAF lasting longer than 30 seconds occurred in 98 patients (31.6%). Baseline preoperative hs-CRP levels did not differ significantly between patients who developed POAF and those who remained in sinus rhythm (2.3 ± 1.1 mg/L vs. 2.1 ± 1.0 mg/L, p = 0.12). However, on postoperative day 3, hs-CRP levels peaked significantly higher in the POAF group than in the non-POAF group (154.6 ± 32.4 mg/L vs. 112.3 ± 28.1 mg/L, p < 0.001). Multivariable logistic regression revealed that peak postoperative hs-CRP level on day 3 was an independent predictor of POAF (odds ratio per 10 mg/L increase: 1.18, 95% CI: 1.09–1.28, p < 0.001), alongside advanced age (odds ratio: 1.05 per year, p = 0.01). Elevated early postoperative systemic inflammatory response, indicated by high hs-CRP levels, is strongly linked to POAF, supporting the inflammatory hypothesis of arrhythmogenesis.
Keywords: Atrial fibrillation, Cardiac surgery, High-sensitivity C-reactive protein, Inflammation, Postoperative complications
Received: March 01, 2010; Revised: April 15, 2010; Accepted: May 05, 2010; Published: June 19, 2010
Citation: International Journal of Cardiology, 2010, Vol. 1, No. 6, pp. 41–48, DOI: 10.46882/2010/IJC/000015