Middle-aged men with increased waist circumference and elevated C-reactive protein level are at higher risk for postoperative atrial fibrillation following coronary artery bypass grafting surgery.

Description

The objectives of this study were to determine which features of the metabolic syndrome were associated with postoperative atrial fibrillation (POAF) following coronary artery bypass graft surgery, to test if abdominal obesity was associated with a greater post-operative inflammatory response and to assess if features of the metabolic syndrome interact with inflammation and oxidative stress with regard to POAF. In the whole cohort of 2,214 male patients, 19,6% developed POAF. In a univariate analysis, body mass index and waist circumference were significantly associated with increased incidence of POAF. However, in a multivariate analysis, only an elevated waist circumference (>102 cm) and older age were independent predictors of POAF. In a nested case-control study, C-reactive protein, interleukin-6 and thiobarbituric acid-reactive substance concentrations were not different between patients with/without POAF. Nevertheless, patients characterized by both elevated waist circumference and C-reactive protein (>1.5 mg/l) or interleukin-6 (>2.2 pg/ml) levels were at highest risk of developing POAF. The editorial by Bell and O’Keefe briefly discussed the atrial fibrillation disease, the metabolic syndrome and its inflammatory component, the coronary artery bypass graft surgery and its association with inflammation and anti-inflammatory agents which could be used to treat POAF. In closing, they recognized that clinical trials are needed to assess the possibility of avoiding POAF and its associated negative outcomes by using preoperative anti-inflammatory drugs.