Intihar Urska, Krasniqi Arta, Djordjevic Anze, Zmazek Jan, Avdagic Harun, Ksela Jus, Antonic Miha
Department of Cardiac Surgery, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia.
Faculty of Natural Sciences and Mathematics, University of Maribor, 2000 Maribor, Slovenia.
Medicina (Kaunas). 2025 Apr 22;61(5):778. doi: 10.3390/medicina61050778.
: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, associated with increased morbidity and prolonged hospital stays. Oxidative stress has been implicated in POAF pathogenesis, with malondialdehyde (MDA), a marker of lipid peroxidation, proposed as a potential biomarker. However, conflicting evidence exists regarding its predictive value. This study aimed to assess the association between serum MDA levels and POAF incidence in patients undergoing cardiac surgery. : This prospective observational study included 99 consecutive patients undergoing elective on-pump cardiac surgery. Patients with preoperative atrial fibrillation, chronic kidney disease requiring dialysis, or emergency surgery were excluded. Blood samples for MDA measurement were collected at six perioperative time points: preoperatively, intraoperatively after aortic clamp release, and at 8, 24, 48, and 72 h postoperatively. Patients were monitored for new-onset POAF during the first three postoperative days. Statistical analyses included independent samples -tests, Mann-Whitney U-tests, and Fisher's exact tests, with significance set at < 0.05. : POAF occurred in 33 (33%) patients. Patients who developed POAF were significantly older ( = 0.017) and had higher EuroSCORE II values ( = 0.019). No significant differences were observed in serum MDA concentrations between POAF and non-POAF patients at any measured time point. The incidence of POAF was higher in patients undergoing valvular surgery ( = 0.014). : Serum MDA levels were not associated with POAF development, suggesting that lipid peroxidation alone may not play a central role in POAF pathogenesis. These findings challenge the predictive value of MDA for POAF risk stratification. Future research should explore alternative oxidative stress markers and their potential therapeutic implications in POAF prevention.
术后心房颤动（POAF）是心脏手术后常见的并发症，与发病率增加和住院时间延长有关。氧化应激被认为与POAF的发病机制有关，丙二醛（MDA）作为脂质过氧化的标志物，被提议作为一种潜在的生物标志物。然而，关于其预测价值存在相互矛盾的证据。本研究旨在评估心脏手术患者血清MDA水平与POAF发生率之间的关联。：这项前瞻性观察性研究纳入了99例连续接受择期体外循环心脏手术的患者。排除术前有心房颤动、需要透析的慢性肾病或急诊手术的患者。在围手术期的六个时间点采集用于测量MDA的血样：术前、主动脉夹松开后术中以及术后8、24、48和72小时。术后前三天对患者进行新发POAF监测。统计分析包括独立样本t检验、曼-惠特尼U检验和费舍尔精确检验，显著性设定为<0.05。：33例（33%）患者发生POAF。发生POAF的患者年龄显著更大（P = 0.017）且欧洲心脏手术风险评估系统II（EuroSCORE II）值更高（P = 0.019）。在任何测量时间点，POAF患者和非POAF患者的血清MDA浓度均未观察到显著差异。瓣膜手术患者的POAF发生率更高（P = 0.014）。：血清MDA水平与POAF的发生无关，这表明单独的脂质过氧化可能在POAF发病机制中不发挥核心作用。这些发现质疑了MDA对POAF风险分层的预测价值。未来的研究应探索替代的氧化应激标志物及其在预防POAF中的潜在治疗意义。
