1
|
Liu Y, Xie E, Yang Y, Han Z, Yu C, Hua K, Yang X. Increased IL-12p70 Levels in Intraoperative Pericardial Fluid Are Predictive of Postoperative Atrial Fibrillation Onset after Coronary Artery Bypass Surgery. Rev Cardiovasc Med 2024; 25:166. [PMID: 39076502 PMCID: PMC11267208 DOI: 10.31083/j.rcm2505166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 07/31/2024] Open
Abstract
Background Postoperative atrial fibrillation (POAF) is a frequent complication of heart surgery, prolonging hospital stays, as well as increasing morbidity and mortality rates. While previous studies have investigated the determinants influencing atrial fibrillation (AF) following heart surgery, the specific risk factors contributing to POAF occurrence after coronary artery bypass graft surgery (CABG) are not well understood. Here we used the human magnetic Luminex assay to assess whether biomarkers, particularly cytokines, within intraoperative pericardial fluid could serve as predictive markers for POAF onset among CABG individuals. Methods In this study we identified 180 patients who underwent CABG with no atrial arrhythmia history. The human magnetic Luminex assay was used to quantify the levels of 36 cytokines in pericardial fluid samples collected during the surgery. The occurrence of POAF was continuously monitored, using both postoperative electrocardiograms and telemetry strips, until the time of discharge. Results In our cohort of 124 patients, POAF was observed in 30 patients, accounting for 24.19% of the study population. These patients exhibited significantly higher levels of interleukin (IL)-12p70 in their intraoperative pericardial fluids compared to those with normal sinus rhythms (SR, p < 0.001). Subsequently, IL-12p70 was found to be an independent risk factor for POAF, and receiver operating characteristic (ROC) analysis established a cut-off threshold for predicting POAF onset of 116.435 pg/mL, based on the maximum Youden index (area under the curve: 0.816). Conclusions this study establishes a significant association between elevated IL-12p70 levels in intraoperative pericardial fluid and the risk of POAF, particularly when IL-12p70 concentrations exceed the identified cut-off value of 116.435 pg/mL. These findings suggest that IL-12p70 levels could potentially be utilized as a predictive biomarker for the onset of POAF in patients undergoing CABG. This marker may aid in the early identification and management of patients at heightened risk for this complication.
Collapse
Affiliation(s)
- Yuhua Liu
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
| | - Enzehua Xie
- Department of Cardiovascular Surgery, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 100037 Beijing, China
| | - Yunxiao Yang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
| | - Zhongyi Han
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
| | - Cuntao Yu
- Department of Cardiovascular Surgery, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, 100037 Beijing, China
| | - Kun Hua
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
| | - Xiubin Yang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China
| |
Collapse
|
2
|
Zhang C, Li H, Han M. Effect of atrial fibrillation on plasma galectin-3 and soluble CD40 ligand levels in patients with ischemic cardiomyopathy. J Int Med Res 2023; 51:3000605231194457. [PMID: 37656969 PMCID: PMC10585127 DOI: 10.1177/03000605231194457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 07/27/2023] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVE To reveal the significance of plasma galectin-3 and soluble CD40 ligand (sCD40L) levels in patients with ischemic cardiomyopathy (ICM) combined with atrial fibrillation. METHODS In this case-control study, the case group comprised 60 patients with ICM combined with atrial fibrillation and the control group comprised patients with ICM without atrial fibrillation. Plasma galectin-3 and sCD40L levels, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), and left ventricular diameter (LVD) were compared. RESULTS The plasma galectin-3 and sCD40L levels, LAD, and LVD were higher and the LVEF was lower in the case than control group. In the case group, the plasma galectin-3 and sCD40L levels were positively correlated with the LAD and LVD but negatively correlated with the LVEF. The area under the receiver operating characteristic curve of the plasma galectin-3 and sCD40L levels in the diagnosis of ICM combined with atrial fibrillation was 0.857 (95% confidence interval, 0.792-0.923) and 0.724 (95% confidence interval, 0.634-0.814), respectively. CONCLUSION The plasma galectin-3 and sCD40L levels are significantly elevated in patients with ICM combined with atrial fibrillation. Although both may have predictive value in the diagnosis of ICM combined with atrial fibrillation, galectin-3 may have the higher predictive value.
Collapse
Affiliation(s)
- Chi Zhang
- Department of Cardiovascular Medicine, The Eighth Hospital of Wuhan, Wuhan City, Hubei Province, China
| | - HongJun Li
- Department of Surgery, The Eighth Hospital of Wuhan, Wuhan City, Hubei Province, China
| | - Mei Han
- Department of Cardiovascular Medicine, The Eighth Hospital of Wuhan, Wuhan City, Hubei Province, China
| |
Collapse
|
3
|
Yang Y, Du Z, Fang M, Ma Y, Liu Y, Wang T, Han Z, Peng Z, Pan Y, Qin H, Qin Y, Jiang Y, Tu P, Guo X, Lu Y, Yang X, Hua K. Metabolic signatures in pericardial fluid and serum are associated with new-onset atrial fibrillation after isolated coronary artery bypass grafting. Transl Res 2023; 256:30-40. [PMID: 36638862 DOI: 10.1016/j.trsl.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/12/2022] [Accepted: 01/03/2023] [Indexed: 01/12/2023]
Abstract
Postoperative atrial fibrillation (POAF) is a common complication of coronary artery bypass grafting (CABG) procedures. However, the molecular mechanism of POAF remains poorly understood, hence the absence of effective prevention strategies. Here we used targeted metabolomics on pericardial fluid and serum samples from CABG patients to investigate POAF-associated metabolic alterations and related risk prediction of new-onset AF. Nine differential metabolites in various metabolic pathways were found in both pericardial fluid and serum samples from patients with POAF and without POAF. By using machine learning algorithms and regression models, a 4-metabolite (aceglutamide, ornithine, methionine, and arginine) risk prediction model was constructed and showed accurate performance in predicting POAF in both discovery and validation sets. This work extends the metabolic insights of the cardiac microenvironment and blood in patients with POAF and paves the way for the use of targeted metabolomics for predicting POAF in patients with CABG surgery.
Collapse
Affiliation(s)
- Yunxiao Yang
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhiyong Du
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Meng Fang
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Ying Ma
- National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, State Key Laboratory of Dao-di Herbs, Beijing, China
| | - Yuhua Liu
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Tianguang Wang
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhongyi Han
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhan Peng
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yilin Pan
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Haokai Qin
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yanwen Qin
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yong Jiang
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Pengfei Tu
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Xiaoyu Guo
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Yingyuan Lu
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, China.
| | - Xiubin Yang
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
| | - Kun Hua
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
4
|
Fleet H, Pilcher D, Bellomo R, Coulson TG. Predicting atrial fibrillation after cardiac surgery: a scoping review of associated factors and systematic review of existing prediction models. Perfusion 2023; 38:92-108. [PMID: 34405746 DOI: 10.1177/02676591211037025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Postoperative atrial fibrillation (POAF) is common after cardiac surgery and associated with increased hospital length of stay, patient morbidity and mortality. We aimed to identify factors associated with POAF and evaluate the accuracy of available POAF prediction models. METHODS We screened articles from Ovid MEDLINE® and PubMed Central® (PMC) and included studies that evaluated risk factors associated with POAF or studies that designed or validated POAF prediction models. We only included studies in cardiac surgical patients with sample size n ⩾ 50 and a POAF outcome group ⩾20. We summarised factors that were associated with POAF and assessed prediction model performance by reviewing reported calibration and discriminative ability. RESULTS We reviewed 232 studies. Of these, 142 fulfilled the inclusion criteria. Age was frequently found to be associated with POAF, while most other variables showed contradictory findings, or were assessed in few studies. Overall, 15 studies specifically developed and/or validated 12 prediction models. Of these, all showed poor discrimination or absent calibration in predicting POAF in externally validated cohorts. CONCLUSIONS Except for age, reporting of factors associated with POAF is inconsistent and often contradictory. Prediction models have low discrimination, missing calibration statistics, are at risk of bias and show limited clinical applicability. This suggests the need for studies that prospectively collect AF relevant data in large cohorts and then proceed to validate findings in external data sets.
Collapse
Affiliation(s)
- Hugh Fleet
- Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - David Pilcher
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Rinaldo Bellomo
- Centre for Integrated Critical Care, The University of Melbourne, Parkville, VIC, Australia
| | - Tim G Coulson
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
- Centre for Integrated Critical Care, The University of Melbourne, Parkville, VIC, Australia
- Department of Anaesthesia, Austin Hospital, Melbourne, VIC, Australia
| |
Collapse
|
5
|
Myeloperoxidase Levels in Pericardial Fluid Is Independently Associated with Postoperative Atrial Fibrillation after Isolated Coronary Artery Bypass Surgery. J Clin Med 2022; 11:jcm11237018. [PMID: 36498593 PMCID: PMC9736356 DOI: 10.3390/jcm11237018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Postoperative atrial fibrillation (POAF) is the most common complication after surgery for atherosclerotic cardiovascular disease (ASCVD) and leads to extended hospital stays and increased mortality. Myeloperoxidase (MPO) in postoperative pericardial drainage fluid is associated with an increased risk of POAF; however, the correlations between MPO in intraoperative pericardial fluid and POAF remain largely unknown. The aim of the study was to evaluate whether MPO is associated with POAF. METHODS A total of 97 patients with no history of atrial arrhythmia who had undergone coronary artery bypass surgery (CABG) were identified. We prospectively measured the levels of MPO in intraoperative pericardial fluid and blood using the human magnetic Luminex assay. Then, the occurrence of atrial fibrillation was continuously observed by postoperative ECG and telemetry strips until discharge. RESULTS Our data showed that POAF occurred in 24 of 97 patients (24.74%). MPO levels in blood were higher in the POAF group than the SR group (p = 0.064). Patients with POAF had significantly higher intraoperative pericardial fluid MPO levels than patients who remained in SR (p = 0.021). There was no significant correlation between pericardial fluid MPO levels and blood MPO levels (r = -0.47, p = 0.770). In a multivariable logistic regression model, pericardial fluid MPO levels were significantly associated with a higher risk of POAF (odds ratio = 1.016, 95% confidence interval, 1.001-1.031; p = 0.031). CONCLUSIONS Higher intraoperative pericardial fluid MPO levels are linked with POAF in patients undergoing CABG. This finding provides insight into a possible mechanism of MPO in pericardial fluid increase susceptibility to developing POAF in patients undergoing CABG.
Collapse
|
6
|
Qian SS, Crandell I, Hanlon A, Joseph M, Poelzing S. Predictive Capability of Metabolic Panels for Postoperative Atrial Fibrillation in Cardiac Surgery Patients. J Surg Res 2022; 278:271-281. [PMID: 35636203 PMCID: PMC9764088 DOI: 10.1016/j.jss.2022.04.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 04/13/2022] [Accepted: 04/22/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Postoperative atrial fibrillation (POAF) occurs in up to 65% of cardiac surgery patients and is associated with an increased risk for stroke and mortality. Electrolyte disturbances in sodium (Na+), potassium (K+), total calcium (Ca2+), chloride (Cl-), and magnesium (Mg2+) are predisposing factors for POAF, but these imbalances are yet to be used to predict POAF. The purpose of this study is to determine whether the development of POAF can be predicted by blood plasma ionic composition. METHODS Metabolic panels of patients with no prior history of atrial fibrillation who did (n = 763) and did not develop POAF (n = 2144) after cardiac surgery were obtained from the Carilion Clinic electronic medical record system. We initially evaluated serum Na+, K+, Ca2+, Cl-, and Mg2+ in the two groups using descriptive statistics via scatter and spaghetti plots and then with predictive modeling via logistic regression and random forest models. RESULTS Neither scatter nor spaghetti plots of electrolyte data revealed a significant difference between those who did and did not develop POAF. Two logistic regression models and two random forest models with POAF status as the outcome were generated using the first observation for each electrolyte and the coefficient of the linear regression, which was obtained from a linear fit of the scatter plot. The random forest model using the first observation had a sensitivity of only 12.2%, but all four models had specificities more than 97%. CONCLUSIONS Neither of the two logistic regression nor two random forest models were able to effectively predict the development of POAF from plasma ionic concentrations, but the random forest models effectively classified patients who would not develop POAF.
Collapse
Affiliation(s)
- Steve S Qian
- Department of Medicine, University of Florida College of Medicine, Gainesville, Florida.
| | - Ian Crandell
- Virginia Tech Center for Biostatistics and Health Data Science, Roanoke, Virginia
| | - Alexandra Hanlon
- Virginia Tech Center for Biostatistics and Health Data Science, Roanoke, Virginia
| | - Mark Joseph
- Division of Cardiothoracic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, Virginia; Fralin Biomedical Research Institute, Roanoke, Virginia
| | | |
Collapse
|
7
|
Hossaini Alhashemi S, Mohammadpour AH, Heidari R, Nikoo MH, Nemati MH, Vazin A. The effect of nanocurcumin on the incidence of atrial fibrillation, and markers of inflammation and oxidative stress level after coronary artery bypass graft surgery: A randomized, double-blind, placebo-controlled clinical study. AVICENNA JOURNAL OF PHYTOMEDICINE 2022; 12:503-513. [PMID: 36249454 PMCID: PMC9516398 DOI: 10.22038/ajp.2022.20201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/12/2022] [Accepted: 02/27/2022] [Indexed: 11/06/2022]
Abstract
Objective Postoperative atrial fibrillation (POAF) is the most frequent dysrhythmias observed following coronary artery bypass graft (CABG) surgery. Several studies have shown the beneficial effects of curcumin on cardiovascular diseases; however, there is no clinical trial to examine its effect on POAF. This randomized, double-blind, placebo-controlled clinical study was designed to evaluate the prophylactic effects of a nano-formulation of curcumin (SinaCurcumin™) versus placebo on POAF and levels of biomarkers of inflammation and oxidative stress in patients undergoing CABG surgery. Materials and Methods A total of 234 eligible patients were randomized to receive 240 mg curcumin nano-formulation or placebo three days prior to the surgery and on the first four postoperative days. The occurrence of POAF was monitored for at least 96 hr after the surgery. Also, C-reactive protein (hs-CRP), malondialdehyde (MDA) and glutathione (GSH) levels were assessed at baseline and the end of the study. Results Analyses were done in the intention-to-treat population. No significant difference was observed in the occurrence of POAF between the treatment (9.5%) and placebo (11.5%) groups. Also, curcumin intervention did not alter serum concentration of the hs-CRP, MDA, or GSH in comparison with placebo. Conclusion In conclusion, it seems that perioperative treatment with SinaCurcumin™ did not prevent POAF after CABG surgery.
Collapse
Affiliation(s)
- Samira Hossaini Alhashemi
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Hooshang Mohammadpour
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran,Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding Authors: Tel: +98-7132424128, Fax: +98-7132424126, , ,
| | - Reza Heidari
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Nikoo
- Department of Cardiology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran,Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hassan Nemati
- Department of Cardiac Surgery, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding Authors: Tel: +98-7132424128, Fax: +98-7132424126, , ,
| | - Afsaneh Vazin
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding Authors: Tel: +98-7132424128, Fax: +98-7132424126, , ,
| |
Collapse
|
8
|
Choi HJ, Seo EJ, Choi JS, Oh SJ, Son YJ. Perioperative risk factors for new-onset postoperative atrial fibrillation among patients after isolated coronary artery bypass grafting: A retrospective study. J Adv Nurs 2021; 78:1317-1326. [PMID: 34519375 DOI: 10.1111/jan.15045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/26/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
AIMS Incidence of atrial fibrillation is considerably high after open heart surgery, which may prolong hospitalization and increase mortality. The aim of the present study is to investigate the perioperative risk factors for the occurrence of new-onset atrial fibrillation following isolated coronary artery bypass grafting. DESIGN A retrospective study. METHODS A total of 327 Korean patients recorded to have undergone first-time isolated coronary artery bypass grafting and no preoperative history of atrial fibrillation were included. The data were obtained from electronic health record from January 2010 to December 2019 at a tertiary care hospital. Predictors of new-onset atrial fibrillation after the surgery were identified by multivariate logistic regression analysis. RESULTS The incidence rate of new-onset atrial fibrillation after coronary artery bypass grafting was approximately 28.4%, and the highest occurrence rate was 44.1% on postoperative day 2. Our main finding showed that advanced age was the strongest predictor of atrial fibrillation after coronary artery bypass grafting. In addition, history of stroke and depression, chronic obstructive pulmonary disease and intraoperative use of intra-aortic balloon pump were shown to be the risk factors. CONCLUSION Our findings showed that approximately 28% patients had new-onset atrial fibrillation after the surgery. Healthcare professionals should proactively assess risk factors for postoperative atrial fibrillation and focus more on older adults with pre-existing comorbidities, such as stroke, depression and chronic obstructive pulmonary disease. IMPACT Older adults with history of stroke, depression and comorbid chronic obstructive pulmonary disease should be carefully monitored closely during perioperative period. The study highlights that early assessment of new-onset postoperative atrial fibrillation can contribute to promote the quality of nursing care and frontline nurses may be a vital role in timely detection of atrial fibrillation after surgery. Prospective studies are required to identify the mechanisms connecting perioperative risk factors for atrial fibrillation after cardiac surgery.
Collapse
Affiliation(s)
- Hong-Jae Choi
- Graduate School of Nursing, Chung-Ang University, Seoul, South Korea
| | - Eun Ji Seo
- College of Nursing, Research Institute of Nursing Science, Ajou University, Suwon, South Korea
| | - Jae-Sung Choi
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Se Jin Oh
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| |
Collapse
|
9
|
Surface Acoustic Wave Sensor for C-Reactive Protein Detection. SENSORS 2020; 20:s20226640. [PMID: 33228249 PMCID: PMC7699588 DOI: 10.3390/s20226640] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/21/2022]
Abstract
A surface acoustic wave (SAW) sensor was investigated for its application in C-reactive protein (CRP) detection. Piezoelectric lithium niobate (LiNbO3) substrates were used to study their frequency response characteristics in a SAW sensor with a CRP sensing area. After the fabrication of the SAW sensor, the immobilization process was performed for CRP/anti-CRP interaction. The CRP/anti-CRP interaction can be detected as mass variations in the sensing area. These mass variations may produce changes in the amplitude of sensor response. It was clearly observed that a CRP concentration of 0.1 μg/mL can be detected in the proposed SAW sensor. A good fitting linear relationship between the detected insertion loss (amplitude) and the concentrations of CRP from 0.1 μg/mL to 1 mg/mL was obtained. The detected shifts in the amplitude of insertion loss in SAW sensors for different CRP concentrations may be useful in the diagnosis of risk of cardiovascular diseases.
Collapse
|
10
|
Karabacak K, Kubat E, Akyol FB, Kadan M, Erol G, Doğancı S, Yıldırım V, Bolcal C. The C-reactive protein/albumin ratio as a new predictor for postoperative atrial fibrillation after coronary artery bypass graft surgery. J Card Surg 2020; 35:2747-2753. [PMID: 32725668 DOI: 10.1111/jocs.14898] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/27/2020] [Accepted: 07/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study aimed to investigate the predictive significance of C-reactive protein/albumin ratio for postoperative atrial fibrillation occurrence in patients who were underwent coronary artery bypass graft surgery. METHODS Among 830 patients who underwent coronary artery bypass grafting with cardiopulmonary bypass between January 2016 and February 2020, 137 patients with no prior arrhythmia history were included in this cross sectional study. RESULTS One hundred and thirty-seven (16.5%) patients developed atrial fibrillation in postoperative period. Patients who experienced postoperative atrial fibrillation were more likely to be older but displayed similar rates of diabetes mellitus, hypertension, hypercholesterolemia, cerebrovascular disease, peripheral vascular disease and chronic obstructive pulmonary disease. For prediction of postoperative atrial fibrillation development, diagnostic odds ratio (OR) and positive likelihood ratio of C-reactive protein/albumin ratio value (OR: 1.854; confidence interval [CI]: 1.598-2.142; P < .001) was higher than serum C-reactive protein and albumin levels. (OR: 1.159; CI: 1.115-1.201; P < .001; OR: 0.438; CI: 0.258-0.865; P < .001, respectively). Which means that C-reactive protein/albumin ratio may detect postoperative atrial fibrillation development better C-reactive protein itself. CONCLUSION Based on our results, patients who developed postoperative atrial fibrillation after coronary artery bypass grafting had significantly higher preoperative C-reactive protein/albumin ratio levels than patients who remained in normal sinus rhythm in the postoperative period. Also, higher C-reactive protein/albumin ratio value was one of the independent predictive factors for postoperative atrial fibrillation. Therefore, we concluded that evaluating preoperative C-reactive protein/albumin ratio value might provide early identification of patients with high risk for postoperative atrial fibrillation.
Collapse
Affiliation(s)
- Kubilay Karabacak
- Department of Cardiovascular Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Emre Kubat
- Department of Cardiovascular Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Furkan Burak Akyol
- Department of Cardiovascular Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Murat Kadan
- Department of Cardiovascular Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Gökhan Erol
- Department of Cardiovascular Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Suat Doğancı
- Department of Cardiovascular Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Vedat Yıldırım
- Department of Anesthesiology and Reanimation, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Cengiz Bolcal
- Department of Cardiovascular Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
11
|
Khan MS, Yamashita K, Sharma V, Ranjan R, Dosdall DJ. RNAs and Gene Expression Predicting Postoperative Atrial Fibrillation in Cardiac Surgery Patients Undergoing Coronary Artery Bypass Grafting. J Clin Med 2020; 9:jcm9041139. [PMID: 32316120 PMCID: PMC7231013 DOI: 10.3390/jcm9041139] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 02/07/2023] Open
Abstract
Postoperative atrial fibrillation (POAF) is linked with increased morbidity, mortality rate and financial liability. About 20–50% of patients experience POAF after coronary artery bypass graft (CABG) surgery. Numerous review articles and meta-analyses have investigated links between patient clinical risk factors, demographic conditions, and pre-, peri- and post-operative biomarkers to forecast POAF incidence in CABG patients. This narrative review, for the first time, summarize the role of micro-RNAs, circular-RNAs and other gene expressions that have shown experimental evidence to accurately predict the POAF incidence in cardiac surgery patients after CABG. We envisage that identifying specific genomic markers for predicting POAF might be a significant step for the prevention and effective management of this type of post-operative complication and may provide critical perspective into arrhythmogenic substrate responsible for POAF.
Collapse
Affiliation(s)
- Muhammad Shuja Khan
- Nora Eccles Harrison Cardiovascular Research and Training Institute, The University of Utah, Salt Lake City, UT 84112, USA; (M.S.K.); (K.Y.); (R.R.)
| | - Kennosuke Yamashita
- Nora Eccles Harrison Cardiovascular Research and Training Institute, The University of Utah, Salt Lake City, UT 84112, USA; (M.S.K.); (K.Y.); (R.R.)
- Division of Cardiovascular Medicine, The University of Utah-Health, Salt Lake City, UT 84132, USA
| | - Vikas Sharma
- Division of Cardiothoracic Surgery, The University of Utah-Health, Salt Lake City, UT 84132, USA;
| | - Ravi Ranjan
- Nora Eccles Harrison Cardiovascular Research and Training Institute, The University of Utah, Salt Lake City, UT 84112, USA; (M.S.K.); (K.Y.); (R.R.)
- Division of Cardiovascular Medicine, The University of Utah-Health, Salt Lake City, UT 84132, USA
- Department of Biomedical Engineering, The University of Utah, Salt Lake City, UT 84112, USA
| | - Derek James Dosdall
- Nora Eccles Harrison Cardiovascular Research and Training Institute, The University of Utah, Salt Lake City, UT 84112, USA; (M.S.K.); (K.Y.); (R.R.)
- Division of Cardiovascular Medicine, The University of Utah-Health, Salt Lake City, UT 84132, USA
- Division of Cardiothoracic Surgery, The University of Utah-Health, Salt Lake City, UT 84132, USA;
- Department of Biomedical Engineering, The University of Utah, Salt Lake City, UT 84112, USA
- Correspondence: ; Tel.: +1-801-587-2036
| |
Collapse
|