Can perioperative C-reactive protein and interleukin-6 levels predict atrial fibrillation after coronary artery bypass surgery?

OBJECTIVE

To examine the relationship between proinflammatory cytokines, such as interleukin-6 (IL-6) and C-reactive protein (CRP) and atrial fibrillation after on-pump coronary artery bypass grafting (CABG).

METHODS

Fifty-four patients with coronary artery disease undergoing elective CABG at the Mazandaran Medical University, Mazandaran, Iran were enrolled in our prospective study in the year 2007. Postoperatively, heart rate and rhythm were continuously monitored for 5 days. Fasting blood samples were taken from all patients to examine quantities of CRP and IL6 the day before surgery and on the second postoperative day in the intensive care unit.

RESULTS

From 54 patients, 11 patients (20.4%) developed atrial fibrillation (AF) after CABG. The median age of patients with AF was 51.45 +/- 10.74 compared with 57.28 +/- 9.04 for patients with sinus rhythm (p=0.072). Cardioplegic time, cross clamp time, and pump time were higher in the AF group, but there was no significant difference between the 2 groups. Preoperative CRP and IL6 levels were higher in patients with AF. The CRP and IL6 increased after CABG in all patients, but it increased more in the AF group.

CONCLUSION

There was a significant relationship between preoperative IL6 and AF in patients who underwent on-pump CABG, but there was no relationship between CRP and AF. Therefore, administration of glucocorticoids, which significantly reduce plasma levels of IL6 can reduce the incidence of AF after on-pump CABG.