Predictive Significance of Plasma Levels of Interleukin-6 and High-Sensitivity C-Reactive Protein in Atrial Fibrillation after Coronary Artery Bypass Surgery

Abstract

Elevated IL-6 and hsCRP levels in patients with postoperative AF suggest inflammatory components have a role of in the pathogenesis of AF.

Systemic vascular cell adhesion molecule-1 predicts the occurrence of post-operative atrial fibrillation

“…Thus, VCAM-1 allows identifying a high-risk population which exhibit an increased level of baseline inflammation associated with endothelial activation, rendering them more susceptible to the inflammatory injury associated to CPB. Baseline hsCRP levels in our cohort was higher than previously described in other groups [15,25], which can be explained by the high-risk profile of our patients. This increased baseline inflammatory state may explain the lack of association in our cohort between pre-operative hsCRP levels and POAF, and may also be a reason for the absence of significant difference in plasma ICAM-1 levels, evidencing the limitations in the interpretation of general inflammatory markers in moderate-to-high-risk populations [46].…”

“…When baseline markers for inflammation and oxidative stress were compared, no significant differences were observed between patients with and without POAF. Baseline inflammatory markers were higher than those previously reported by others [15,25] and they increased significantly after surgery both in patients with or without POAF ( Fig. 1 and Table 2).…”

“…The intriguing possibility that low-level pre-operative inflammation and endothelial dysfunction may serve as substrate for POAF has been evaluated previously without conclusive results [14,15,25]. In our cohort, patients who developed POAF showed no differences in baseline hsCRP, white cell blood count or ESR.…”

“…However, it is not clear whether these factors are a cause or a consequence of the arrhythmia, or if they constitute an expression of a systemic process or local atrial changes [12,13]. The currently held view is that the surgical procedure serves as trigger for POAF in patients with a given substrate that makes them susceptible to development of the arrhythmia [14,15]. However, our ability to identify such patients is inaccurate and remains largely on clinical characteristics [2].…”

Can neutrophil/lymphocyte ratio predict recurrence after electrical cardioversion in non-valvular atrial fibrillation?

“…After cardiac surgery the presence of a relationship between AF development and interleukin 8 (IL-8), IL-6 and increased WBC count has been shown (15)(16)(17). In a very recent study, Rienstra et al (18) examined the 936 participants in the Framingham Heart Study original cohort and found that an increased WBC count was associated with AF incident during 5 years of follow-up.…”