Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
J Thorac Cardiovasc Surg. 2015 Apr;149(4):1175-82.e1. doi: 10.1016/j.jtcvs.2014.11.035. Epub 2014 Nov 21.
Postoperative atrial fibrillation is a major cause of morbidity and mortality for stroke after cardiac surgery. Both systemic inflammation and oxidative stress play a role in the initiation of postoperative atrial fibrillation after cardiac surgery. The possible association between long-term intake of antioxidant-rich foods and postoperative atrial fibrillation incidence was examined in patients undergoing cardiac surgery.
A total of 217 consecutive patients (74% were men; median age, 68.4 years) undergoing cardiac surgery, mainly coronary artery bypass grafting and valve replacement or repair, were recruited from January 2010 to September 2012. Total antioxidant capacity was measured in foods by the Trolox equivalent antioxidant capacity assay. The European Prospective Investigation into Cancer and Nutrition Food Frequency Questionnaire was used for dietary total antioxidant capacity assessment. The association among tertiles of dietary total antioxidant capacity and postoperative atrial fibrillation incidence was assessed using multivariable logistic analysis.
The overall incidence of total arrhythmias and postoperative atrial fibrillation was 42.4% and 38.2%, respectively. In multivariable analysis, after adjustment for age, gender, use of hypoglycemic drugs, physical activity, education, previous diagnosis of atrial fibrillation, and total energy intake, patients in the highest tertile of dietary total antioxidant capacity had a lower risk of postoperative atrial fibrillation than patients in the 2 lowest tertiles (odds ratio, 0.46; 95% confidence interval, 0.22-0.95; P = .048). A restricted cubic spline transformation confirmed the nonlinear relationship between total antioxidant capacity (in continuous scale) and postoperative atrial fibrillation (P = .023). When considering only coronary artery bypass grafting, valve replacement/repair, and combined surgeries, the protective effect on postoperative atrial fibrillation of a diet rich in antioxidants was confirmed.
Long-term consumption of antioxidant-rich foods is associated with a reduced incidence of postoperative atrial fibrillation in patients undergoing cardiac surgery.
心脏手术后的心房颤动是中风后发病率和死亡率的主要原因。全身炎症和氧化应激在心脏手术后的心房颤动的发生中起作用。本研究旨在探讨心脏手术后长期摄入富含抗氧化剂的食物与心房颤动发生率之间的可能关联。
2010 年 1 月至 2012 年 9 月期间，共招募了 217 名连续接受心脏手术（74%为男性；中位年龄 68.4 岁）的患者，主要进行冠状动脉旁路移植术和瓣膜置换或修复术。通过 Trolox 等效抗氧化能力测定法测量食物中的总抗氧化能力。使用欧洲前瞻性癌症与营养食品频率问卷评估膳食总抗氧化能力。采用多变量逻辑分析评估膳食总抗氧化能力三分位数与术后心房颤动发生率之间的关系。
总心律失常和术后心房颤动的总发生率分别为 42.4%和 38.2%。多变量分析调整年龄、性别、使用降糖药物、体力活动、教育程度、先前诊断的心房颤动和总能量摄入后，膳食总抗氧化能力最高三分位数的患者术后心房颤动的风险低于最低三分位数的患者（比值比，0.46；95%置信区间，0.22-0.95；P=0.048）。受限立方样条转换证实了总抗氧化能力（连续尺度）与术后心房颤动之间的非线性关系（P=0.023）。当仅考虑冠状动脉旁路移植术、瓣膜置换/修复术和联合手术时，抗氧化剂丰富的饮食对术后心房颤动的保护作用得到了证实。
心脏手术后长期摄入富含抗氧化剂的食物与术后心房颤动发生率降低相关。
