[冠状动脉搭桥术后房颤]

[Atrial Fibrillation After Coronary Artery Bypass Grafting].

作者信息

Rubanenko O A, Fatenkov O V, Khokhlunov S M, Limareva L V

机构信息

Samara State Medical University, Samara, Russia.

Samara Regional Cardiology Dispensary, Samara, Russia.

出版信息

Kardiologiia. 2017 Apr;57(4):53-57.

PMID:28762905

Abstract

PURPOSE

to identify the role of factors of inflammation and myocardial ischemia in the development of atrial fibrillation (AF) in the early postoperative period after coronary artery bypass grafting (CABG).

METHODS

We enrolled in this study 96 patients with ischemic heart disease who had undergone CABG. Patients were divided into 2 groups: (1) without postoperative AF (n=67, 80.6% men, mean age 57.9+/-7.3 years), (2) with early new-onset AF after CABG (n=29, 86% men, mean age 64.0+/-8.4 years).

RESULTS

AF occurred on average 4.9+/-3.8 days after surgery. Concentrations of interleukin-10, C-reactive protein, fibrinogen, troponin were not significantly different between two groups both before and after CABG. At multivariate analysis the following parameters were related to development of AF in postoperative period: left atrial dimension >41 mm (odds ratio [OR] 3.6 (95% confidence interval [CI] 1.2-5.8, p=0.0002), interleukin-6 level >68 pg/ml (OR 3.2, 95%CI 1.8-4.7, p=0.009), interleukin-8 level >9.5 pg/ml (OR 2.9, 95% CI 1.4-6.7, p=0.009).

CONCLUSION

Our research shows significant increase of interleukin-6 and interleukin-8 in patients with AF after CABG what confirms the role of inflammation factors in development of this complication.

摘要

目的

确定炎症和心肌缺血因素在冠状动脉旁路移植术（CABG）术后早期房颤（AF）发生中的作用。

方法

本研究纳入96例行CABG的缺血性心脏病患者。患者分为两组：（1）无术后房颤组（n = 67，男性占80.6%，平均年龄57.9±7.3岁），（2）CABG术后早期新发房颤组（n = 29，男性占86%，平均年龄64.0±8.4岁）。

结果

房颤平均在术后4.9±3.8天发生。两组患者在CABG术前和术后白细胞介素-10、C反应蛋白、纤维蛋白原、肌钙蛋白浓度均无显著差异。多因素分析显示，以下参数与术后房颤的发生有关：左心房内径>41 mm（比值比[OR] 3.6（95%置信区间[CI] 1.2 - 5.8，p = 0.0002）），白细胞介素-6水平>68 pg/ml（OR 3.2，95%CI 1.8 - 4.7，p = 0.009），白细胞介素-8水平>9.5 pg/ml（OR 2.9，95%CI 1.4 - 6.7，p = 0.009）。