and predominantly nonsmokers (18% versus 46% = 0. were not associated

and predominantly nonsmokers (18% versus 46% = 0. were not associated with AF. Multivariable analysis revealed only improved preoperative BNP Rabbit Polyclonal to Clock. levels as self-employed predictor for postoperative AF (= 0.036). Summary. Elevated preoperative BNP serum levels are associated with the development of post-CABG AF while CRP does not seem to be influential. 1 Intro Atrial fibrillation (AF) happens GYKI-52466 dihydrochloride in 25-40% representing the most common arrhythmia in individuals undergoing isolated coronary artery bypass surgery (CABG) [1-3]. Although it is not a life-threatening rhythm disturbance and may present as self-limiting onset it has major GYKI-52466 dihydrochloride medical and economical implications. It may compromise cardiac function increase 2- to 3-collapse the risk of stroke and thromboembolism result in iatrogenic complications due to additional treatment attempts prolong hospitalization period (by 1-3 days) and elevate treatment cost [3-7]. Numerous studies primarily retrospective have been carried out to clarify the pathogenesis of postoperative AF as well to identify predisposing factors. However the precise etiologic pattern still remains unclear. The proposed contributory factors include inflammation induced by cardiopulmonary bypass beta-blocker withdrawal right GYKI-52466 dihydrochloride coronary artery stenosis atrial ischemia inadequate intraoperative cardiac safety perioperative ischemic injury postoperative pericarditis autonomic imbalance and fluid/electrolyte disturbances during the intra- and postoperative periods [8-14]. Mind natriuretic peptide (BNP) is definitely released in blood circulation primarily from remaining atrial and ventricular myocytes due to pressure and/or volume overload in the heart chambers [15]. The hormone promotes natriuresis diuresis and vasodilatation while blood levels of BNP are raised in individuals with structural cardiac disease particularly those with heart failure. High-sensitivity C-reactive protein (hs-CRP) is an acute-phase protein and an established marker of swelling. In addition elevated CRP levels have been linked to the severity of atherosclerosis risk of coronary events and even long-term end result after CABG [16]. Its arrhythmogenic effect has been postulated to be related to sodium and calcium exchange disturbances following its linkage to phosphocholine [17]. All the aforementioned medical entities offer a appropriate milieu for the development of AF and as long as both biomarkers are related with those onsets; we investigate in our series the part of BNP and CRP in predicting the event of post-CABG AF. 2 Individuals and Methods With this prospective single center study 125 consecutive individuals undergoing isolated coronary artery bypass graft operation (CABG) over a 6-month time period in the Onassis Cardiac Surgery Center were enrolled. Indications for CABG surgery were significant (>60%) disease of the remaining main coronary artery stem ostial stenosis of remaining anterior descending artery two- or three-coronary-vessel disease and symptomatic coronary artery disease unsuitable GYKI-52466 dihydrochloride for percutaneous coronary treatment. All instances were managed on an elective basis. The decision to continue with “on-” or “off-pump” operation was based upon the cosmetic surgeons’ preference which was primarily influenced by individuals/disease characteristics. However there were no uniform criteria among the cosmetic surgeons for the use of either technique. Individuals considered to be at high risk for the development of postoperative AF like those with history of AF on antiarrhythmic medical therapy congestive heart failure at the time of preoperative evaluation and/or concomitant valve surgery those suffering from a chronic inflammatory condition and/or those under medical treatment with amiodarone corticosteroids or non-steroidal antiinflammatory medicines within 30 days prior to CABG surgery were excluded from the study. In all instances the remaining ventricular function was evaluated preoperatively by transthoracic echocardiogram. The degree of diseased coronary vessels as well as the number of distal coronary anastomoses performed on each case was recorded. Individuals undergoing GYKI-52466 dihydrochloride “on-pump” surgery received either antegrade or retrograde cardioplegia. The decision to use intra-aortic balloon pump cardiac inotropic support or temporary pacing was made by the anesthesiologist and/or the doctor and was determined by the patient’s hemodynamic status and rhythm in the operating room and the postoperative.