Rubanenko Olesya, Rubanenko Anatoly, Davydkin Igor
Hospital Therapy Department, Samara State Medical University, 89, Chapaevskaya St., 443099 Samara, Russia.
Propaedeutic Therapy Department, Samara State Medical University, 89, Chapaevskaya St., 443099 Samara, Russia.
Life (Basel). 2023 Oct 10;13(10):2035. doi: 10.3390/life13102035.
The aim of the study was to perform a comprehensive fundamental analysis of the factors of inflammation, oxidative stress, fibrosis, myocardial dysfunction, ischemia and omega-3 index associated with postoperative atrial fibrillation (POAF) after coronary artery bypass graft (CABG) surgery in patients with coronary artery disease. The study involved 158 patients who were admitted to the hospital to undergo CABG surgery. Patients were divided into two groups: group 1 comprised 111 patients without POAF (82% males, median age-62.0 (56.0; 66.0) years), and group 2 comprised 47 patients with POAF (84.4% males, median age-65.0 (61.0; 70.0) years). POAF occurred 5.2 (2.0; 7.0) days after CABG. In all the patients, we evaluated laboratory tests before and 3-4 days after CABG. All the patients also underwent echocardiography. According to results of multifactorial regression analysis, the odds ratio of POAF development for left atrial diameter >41 mm was 4.3 (95% confidence interval (CI) 2.0-9.7, < 0.001), interleukin (IL)-6 postoperative levels >22.07 pg/mL-3.0 (95% CI 1.4-8.2, = 0.006), IL-8 postoperative levels >9.67 pg/mL-2.3 (95% CI 1.2-7.3, = 0.006), superoxide dismutase postoperative levels in plasma >1100.5 U/g-3.2 (95% CI 1.4-9.2, = 0.03), glutathione postoperative levels ≤0.194 micromole/g of hemoglobin-1.9 (95% CI 1.2-6.3, < 0.001), glutathione peroxidase postoperative levels ≤17.36 millimole/g of hemoglobin-2.2 (95% CI 1.1-8.2, < 0.001), glutathione reductase postoperative levels ≤2.99 millimole/g of hemoglobin-2.3 (95% CI, 1.1-5.7, < 0.001), malondialdehyde postoperative levels >1.25 micromole/g of hemoglobin-2.0 (95% CI, 1.2-7.9, < 0.001), NO postoperative levels in plasma >36.4 micromole/L-1.5 (95% CI, 1.1-5.9, < 0.001) and omega-3 index ≤1.59%-2.6 (95% CI 1.5-9.1, < 0.001). Our study showed that increased left atrial diameter, high postoperative levels of inflammatory factors, oxidative stress, fibrosis indicators and omega-3 index were associated with POAF in patients who underwent CABG.
本研究的目的是对冠心病患者冠状动脉旁路移植术（CABG）后与术后房颤（POAF）相关的炎症、氧化应激、纤维化、心肌功能障碍、缺血和ω-3指数等因素进行全面的基础分析。该研究纳入了158例入院接受CABG手术的患者。患者被分为两组：第1组包括111例无POAF的患者（男性占82%，中位年龄为62.0（56.0；66.0）岁），第2组包括47例有POAF的患者（男性占84.4%，中位年龄为65.0（61.0；70.0）岁）。POAF发生于CABG术后5.2（2.0；7.0）天。在所有患者中，我们评估了CABG术前及术后3 - 4天的实验室检查结果。所有患者还接受了超声心动图检查。根据多因素回归分析结果，左心房直径>41 mm时发生POAF的比值比为4.3（95%置信区间（CI）2.0 - 9.7，P<0.001），术后白细胞介素（IL）-6水平>22.07 pg/mL时为3.0（95% CI 1.4 - 8.2，P = 0.006），术后IL-8水平>9.67 pg/mL时为2.3（95% CI 1.2 - 7.3，P = 0.006），术后血浆中超氧化物歧化酶水平>1100.5 U/g时为3.2（95% CI 1.4 - 9.2，P = 0.03），术后谷胱甘肽水平≤0.194微摩尔/克血红蛋白时为1.9（95% CI 1.2 - 6.3，P<0.001），术后谷胱甘肽过氧化物酶水平≤17.36毫摩尔/克血红蛋白时为2.2（95% CI 1.1 - 8.2，P<0.001），术后谷胱甘肽还原酶水平≤2.99毫摩尔/克血红蛋白时为2.3（95% CI 1.1 - 5.7，P<0.001），术后丙二醛水平>1.25微摩尔/克血红蛋白时为2.0（95% CI 1.2 - 7.9，P<0.001），术后血浆中一氧化氮水平>36.4微摩尔/升时为1.5（95% CI 1.1 - 5.9，P<0.001），以及ω-3指数≤1.59%时为2.6（95% CI 1.5 - 9.1，P<0.001）。我们的研究表明，左心房直径增大、术后炎症因子水平升高、氧化应激、纤维化指标以及ω-3指数与接受CABG手术患者的POAF相关。
