Predictive significance of plasma levels of interleukin-6 and high-sensitivity C-reactive protein in atrial fibrillation after coronary artery bypass surgery


Ucar H. I. , Tok M., Atalar E. , Dogan O. F. , Oc M., Farsak B., ...Daha Fazla

HEART SURGERY FORUM, cilt.10, sa.2, 2007 (SCI İndekslerine Giren Dergi) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 10 Konu: 2
  • Basım Tarihi: 2007
  • Doi Numarası: 10.1532/hsf98.20061175
  • Dergi Adı: HEART SURGERY FORUM

Özet

Background. Postoperative atrial fibrillation (AF) plays a major role in the determination of hemodynamic deterioration and can be associated with cardiovascular events after coronary artery surgery. Elevated interleukin (IL)-6 and Creactive protein (CRP) levels in patients with AF suggest a role of inflammation in the pathogenesis of AF. We conducted a study to investigate the correlation between postoperative AF and IL-6 and high-sensitivity CRP (hsCRP). Materials and Methods. Forty-nine patients with a mean age of 60.3 +/- 10.7 years were enrolled in this study. Preoperative and postoperative first day blood samples were collected to assess the IL-6 and hsCRP levels. IL-6 levels were measured by enzyme-linked immunosorbent assay, and hsCRP was measured by rate turbidimetry method. Results. Fourteen patients (28.5%) developed AF postoperatively. Patients who developed AF showed elevated serum concentrations of postoperative first day IL-6 ( P < .001), preoperative hsCRP ( P < 005), and postoperative first day hsCRP ( P < 0.001). Preoperative hsCRP levels ( P < .002) and postoperative first day IL-6 ( P < .001) and hsCRP ( P < 0.001) levels were associated with prolonged endotracheal intubation time. Prolonged intensive care unit stay showed significant correlations with elevated levels of preoperative hsCRP (P < 0.002) and postoperative first day IL-6 ( P < 0.001) and hsCRP (P < 0.001). There was also statistical significance between the AF+ and AF- groups regarding intensive care unit stay and endotracheal intubation times ( P = .001 and P = .001, respectively). Cut-off points for postoperative first day IL-6, preoperative hsCRP, and postoperative first day hsCRP were 46.4 pg/mL ( sensitivity = 92.9% and specificity = 80%), 0.46 mg/L ( sensitivity = 71% and specificity = 75%), and 17.9 mg/L ( sensitivity = 92.9% and specificity = 78%), respectively. Conclusions. Elevated IL-6 and hsCRP levels in patients with postoperative AF suggest inflammatory components have a role of in the pathogenesis of AF.