Clinical, echocardiographic parameters and markers of oxidative stress associated with atrial fibrillation in patients undergoing coronary artery bypass graft surgery

Aim. To estimate the association of clinical, echocardiographic parameters and markers of oxidative stress with postoperative atrial fibrillation (POAF) in patients with coronary artery disease (CAD) undergoing coronary artery bypass graft (CABG) surgery.

Material and methods. This case-control study included 158 patients with CAD who were scheduled for CABG surgery. Patients were divided into two groups: group 1 (n=111) — patients without POAF (men — 82%, median age — 62,0 [56,0;66,0] years); group 2 (n=47) — patients with POAF (men — 84,4%, median age — 65,0 [61,0;70,0] years). The median of POAF development was 5,2 [2,0;7,0] days after CABG. We studied plasma and erythrocyte superoxide dismutase (SOD) levels, plasma nitrogen oxide and myeloperoxidase levels, erythrocyte levels of catalase, malondialdehyde, reduced glutathione, glutathione reductase and glutathione peroxidase, and advanced oxidation protein products. The determination was carried out before and on average 3-4 days after CABG. All the patients also underwent echocardiography.

Results. Multivariate regression revealed following parameters associated with POAF: left atrial diameter >41 mm (odds ratio (OR) 4,1,95% confidence interval (CI) 1,7-8,9, р=0,001), postoperative plasma levels of SOD >1100,5 U/g (OR 3,0, 95% CI 1,3-9,7, р=0,04), postoperative levels of reduced glutathione <0,194 Mmol/g Hb (OR 1,6, 95% CI 1,1-6,8, р=0,002), postoperative levels of glutathione peroxidase <17,36 mmol/g Hb (OR 1,9, 95% CI 1,1-7,8, р=0,0005), postoperative levels of glutathione reductase <2,99 mmol/g Hb (OR 2,1, 95% CI, 1,1-5,9, р=0,004), postoperative levels of malondialdehyde >1,25 Mmol/g Hb (OR 1,9, 95% CI 1,1-7,2, р<0,0001), postoperative plasma levels of nitrogen oxide >36,4 Mmol/l (OR 1,4, 95% CI 1,03-4,8, р=0,001).

Conclusion. Our study showed significant association of increased left atrial diameter, high activity of oxidative stress and low activity of antioxidant system with POAF in patients with CAD undergoing CABG surgery.

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