Preoperative plasma predictive factors of new-onset atrial fibrillation after coronary artery bypass graft surgery: A propensity score matching study

  • Hao XU ,
  • Guo-dong ZHANG ,
  • Guang-pu FAN ,
  • Yu CHEN
Expand
  • Department of Cardiac Surgery, Heart Center, Peking University People’s Hospital, Beijing 100044, China

Received date: 2019-12-02

  Online published: 2021-12-13

Abstract

Objective: To study the relationship between preoperative plasma interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), homocysteine (Hcy), endothelin-1 (ET-1) levels and new-onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG). Methods: In the study, 148 patients who underwent isolated CABG in Peking University People’s Hospital from January 1, 2017 to December 30, 2017 were enrolled, of whom 39 had new-onset AF. The fasting venous blood was collected within 24 hours before the surgery. The preoperative plasma IL-1, IL-6, TNF-α, Hcy, ET-1 levels were detected by enzyme-linked immunosorbent assay (ELISA). The patients were divided into AF group and non-AF group according to whether new-onset AF occurred after operation. After 1 ∶1 propensity score matching (PSM), 38 people were in each group. The paired sample t-tests were performed on the five factors’ concentrations of the matched AF group and the non-AF group respectively. If the concentration values did not conform to the normal distribution, the Wilcoxon signed rank sum test was performed. Conditional Logistic regression analysis was performed on the concentrations of the five indicators to explore the correlation between preoperative plasma concentrations of IL-1, IL-6, TNF-α, Hcy, ET-1 and postoperative new-onset AF after CABG. Results: After a 1 ∶1 propensity score matching, the AF group was comparable to the non-AF group. The concentrations of IL-1, IL-6, TNF-α, and Hcy in the AF group were higher than those in the non-AF group [(0.867±0.589) ng/L vs. (0.742±0.262) ng/L, 21.55 (6.50, 209.90) ng/L vs. 17.95 (3.60, 86.70) ng/L, 20.30 (5.70, 361.00) ng/L vs. 21.50 (7.50, 251.80) ng/L, (0.29±0.11) μmol/L vs. (0.27±0.09) μmol/L], but the differences were not statistically significant (P=0.165, P=0.891, P=0.817, P=0.285). After the conditional Logistic regression analysis, the above four variables were not predictors of new-onset AF after CABG. The concentrations of ET-1 in the matched AF group and non-AF group were (25.80±6.20) ng/L and (29.10±8.54) ng/L, respectively. The correlation between preoperative low plasma ET-1 concentration and the new-onset AF after CABG were statistically significant (P=0.003). After conditional Logistic regression analysis, preoperative plasma ET-1 concentration was correlated with postoperative new-onset AF after CABG (P=0.039, adjusted OR=0.637, 95%CI: 0.415-0.977). Conclusion: The levels of preoperative plasma IL-1, IL-6, TNF-α and Hcy in the patients with new-onset AF after CABG were higher than those in the patients without AF, but the difference was not statistically significant. Preoperative plasma low ET-1 concentration was statistically associated with new-onset AF after CABG.

Cite this article

Hao XU , Guo-dong ZHANG , Guang-pu FAN , Yu CHEN . Preoperative plasma predictive factors of new-onset atrial fibrillation after coronary artery bypass graft surgery: A propensity score matching study[J]. Journal of Peking University(Health Sciences), 2021 , 53(6) : 1139 -1143 . DOI: 10.19723/j.issn.1671-167X.2021.06.022

References

[1] El-Chami MF, Kilgo P, Thourani V, et al. New-onset atrial fibrillation predicts long-term mortality after coronary artery bypass graft[J]. J Am Coll Cardiol, 2010, 55(13):1370-1376.
[2] 孙源君. 心房颤动与肺栓塞的关系及治疗[J]. 中国循环杂志, 2018, 33(3):307-309.
[3] Hak L, Mysliwska J, Wieckiewicz J, et al. Interleukin-2 as a predictor of early postoperative atrial fibrillation after cardiopulmonary bypass graft (CABG)[J]. J Interferon Cytokine Res, 2009, 29(6):327-332.
[4] Wu ZK, Laurikka J, Vikman S, et al. High postoperative interleukin-8 levels related to atrial fibrillation in patients undergoing coronary artery bypass surgery[J]. World J Surg, 2008, 32(12):2643-2649.
[5] 王淑娟, 林祥灿. 血浆NT-proBNP水平与同型半胱氨酸对糖尿病合并心房颤动的相关性研究[J]. 医学信息, 2018, 31(14):169-171.
[6] 刘明, 魏兰芳, 薛洋, 等. 血清同型半胱氨酸与心房颤动的关系[J]. 中国循证心血管医学杂志, 2017, 9(1):117-118.
[7] Wang H, Liu J, Fang P, et al. Big endothelin-1 as a predictor of atrial fibrillation recurrence after primary ablation only in patients with paroxysmal atrial fibrillation[J]. Herz, 2012, 37(8):919-925.
[8] 徐颖. 高敏C反应蛋白、脑钠肽、内皮素1与非瓣膜性心房颤动关系的探讨[D]. 天津: 天津医科大学, 2011.
[9] 洪钰杰, 钟国强, 蒋智渊, 等. 内皮素-1在心房颤动发生中的机制探讨[J]. 中国循环杂志, 2016, 31(2):146-150.
[10] 郭瑾. 焦虑抑郁患者血清NO、ET-1、vWF表达水平研究[D]. 太原: 山西医科大学, 2018.
[11] 邓晓雯. KL-6、ET-1在OSAHS患者中的血清水平及其意义[D]. 湖南衡阳: 南华大学, 2014.
[12] 马朝晖, 张仁福, 姜辉, 等. 三种心脏停搏液对心肌保护的对比研究[J]. 中国循环杂志, 2000, 15(1):40-42.
Outlines

/