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Ann Thorac Surg 2007;83:1332-1337
© 2007 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Postoperative Atrial Fibrillation is Not Correlated to C-Reactive Protein

Anders J. Ahlsson, MDa,*, Lennart Bodin, PhDb, Olof H. Lundblad, MDa, Anders G. Englund, MD, PhDc

a Departments of Cardiothoracic Surgery and Anesthesiology, Örebro University Hospital, Örebro, Sweden
b Departments of Statistics and Epidemiology, Örebro University Hospital, Örebro, Sweden
c Department of Cardiology, Örebro University Hospital, Örebro, Sweden

Accepted for publication November 16, 2006.

* Address correspondence to Dr Ahlsson, Department of Cardiothoracic Surgery and Anesthesiology, Örebro University Hospital, 701 85 Örebro, Sweden (Email: anders.ahlsson{at}orebroll.se).

Background: The peak incidence of postoperative atrial fibrillation (AF) occurs around the second postoperative day, a time at which serum inflammatory markers are elevated. The aim of this study was to investigate differences between patients with and without postoperative AF with special regard to C-reactive protein (CRP) serum levels.

Methods: The study cohort included all heart surgery patients who had sinus rhythm preoperatively, survived postoperative day 3, and were operated on between July 1, 2004, and June 30, 2005 (n = 524). Any episode of AF during the first 7 postoperative days defined the patient as belonging to the postoperative AF group. Creatine kinase–myocardial band (CK-MB) was measured at postoperative day 1, and CRP was measured preoperatively and at postoperative day 3. Risk factors for postoperative AF were determined using bivariate and multivariate regression analysis.

Results: Of 524 patients, 182 had at least one episode of AF (34.7%). Preoperative and postoperative CRP concentrations did not differ between the groups (postoperative CRP 175.4 ± 64.4 versus 175.3 ± 60.1 mg/L respectively, p = 0.99). Atrial fibrillation patients were significantly older (p < 0.001) and had higher CK-MB levels (33.6 ± 53.1 µg/L versus 22.5 ± 26.7 µg/L, respectively, p = 0.009). The odds ratio for postoperative AF with postoperative CK-MB greater than 70 µg/L was 3.5 (confidence interval: 1.4 to 8.6).

Conclusions: Postoperative AF has no correlation to the inflammatory marker CRP in heart surgery patients. Ischemic myocardial injury might predispose for postoperative AF.




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