PMID- 16439145
OWN - NLM
STAT- MEDLINE
DCOM- 20060608
LR  - 20220318
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 29
IP  - 4
DP  - 2006 Apr
TI  - Relation of inflammatory cytokines to atrial fibrillation after off-pump coronary 
      artery bypass grafting.
PG  - 501-5
AB  - OBJECTIVE: It has been observed that a systemic inflammatory response after 
      on-pump coronary artery bypass grafting (CABG) participates in the pathogenesis 
      of postoperative atrial fibrillation (AF). In patients undergoing off-pump CABG, 
      it is plausible that inflammation is associated with the development of 
      postoperative AF. The present study examined relation of proinflammatory 
      cytokines, which play an important role in the upstream of inflammatory cascade, 
      to the development of AF after off-pump CABG. METHODS: The present study included 
      39 patients undergoing off-pump CABG. Tumor necrosis factor-alpha (TNF-alpha), 
      interleukin (IL)-6, and IL-8, were measured by enzyme-linked immunosorbent assay, 
      on anesthetic induction, after sternotomy before anastomoses, at the completion 
      of anastomoses, 3 and 6h thereafter, and on postoperative days (POD) 1-4. 
      C-reactive protein (CRP) was also measured by turbidimetric immunoassay, 
      preoperatively, and on POD 1, 2, 3, 6, 9, and 13. RESULTS: Eleven patients (28%) 
      developed postoperative AF. Patients with postoperative AF were older (70+/-6.4 
      years vs 60+/-8.8 years, P=0.001); however, there was no difference in other pre- 
      and perioperative variables. TNF-alpha level did not change during the study 
      period. However, IL-8 and CRP levels significantly increased after the surgery, 
      although there was no significant difference between the two groups. IL-6 level 
      also increased after the surgery with its peak at 6h after the completion of 
      anastomoses. IL-6 levels of 3 and 6h after anastomoses were significantly higher 
      in patients with postoperative AF (360+/-143 pg/ml vs 230+/-94 pg/ml, P=0.0047, 
      435+/-175 pg/ml vs 247+/-102 pg/ml, P=0.0005, respectively). Logistic regression 
      analysis indicated that the highest quartile of IL-6 level immediately after the 
      surgery (odds ratio 7.63; 95% CI, 1.06-54.9; P=0.04) and age (odds ratio 1.18; 
      95% CI, 1.01-1.39; P=0.04) independently predict postoperative AF. Furthermore, 
      the maximum level of IL-6 immediately after the surgery significantly correlated 
      to age and intraoperative blood loss (r=0.04, P=0.01, and r=0.47, P=0.04, 
      respectively). CONCLUSIONS: Advanced age was a major risk factor for 
      postoperative AF. Furthermore, inflammatory response induced by surgical trauma 
      was also associated with the development of AF after off-pump CABG.
FAU - Ishida, Keiichi
AU  - Ishida K
AD  - Department of General Surgery, Graduate School of Medicine, Chiba University, 
      Inohana 1-8-1 Chuo-ku, Chiba 260-0856, Japan.
FAU - Kimura, Fumio
AU  - Kimura F
FAU - Imamaki, Mizuho
AU  - Imamaki M
FAU - Ishida, Atsushi
AU  - Ishida A
FAU - Shimura, Hitoshi
AU  - Shimura H
FAU - Kohno, Hiroki
AU  - Kohno H
FAU - Sakurai, Manabu
AU  - Sakurai M
FAU - Miyazaki, Masaru
AU  - Miyazaki M
LA  - eng
PT  - Journal Article
DEP - 20060124
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
RN  - 0 (Biomarkers)
RN  - 0 (Cytokines)
RN  - 0 (Inflammation Mediators)
RN  - 0 (Interleukin-6)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Atrial Fibrillation/*blood/etiology
MH  - Biomarkers/blood
MH  - Coronary Artery Bypass, Off-Pump/*adverse effects
MH  - Coronary Disease/pathology/surgery
MH  - Cytokines/*blood
MH  - Female
MH  - Humans
MH  - Inflammation Mediators/*blood
MH  - Interleukin-6/blood
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
MH  - Systemic Inflammatory Response Syndrome/blood/*etiology
EDAT- 2006/01/28 09:00
MHDA- 2006/06/09 09:00
CRDT- 2006/01/28 09:00
PHST- 2005/09/29 00:00 [received]
PHST- 2005/12/19 00:00 [revised]
PHST- 2005/12/21 00:00 [accepted]
PHST- 2006/01/28 09:00 [pubmed]
PHST- 2006/06/09 09:00 [medline]
PHST- 2006/01/28 09:00 [entrez]
AID - S1010-7940(05)00983-8 [pii]
AID - 10.1016/j.ejcts.2005.12.028 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2006 Apr;29(4):501-5. doi: 10.1016/j.ejcts.2005.12.028. 
      Epub 2006 Jan 24.