Role of red blood cell distribution width and epicardial fat in atrial fibrillation after cardiopulmonary bypass
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Mehmet Akif Inan Training and Research Hospital, Department of Cardiology, Sanliurfa, Turkey
Department of Cardiology, Medova Hospital, Konya, Turkey
Department of Radiology, Magnet Hospital, Ankara, Turkey
Department of Cardiovascular Surgery, Rumi Hospital, Konya, Turkey
Department of Internal Medicine, Anıt Hospital, Konya, Turkey
Online publication date: 2018-01-09
Publication date: 2018-01-09
Electron J Gen Med 2018;15(2):em02
Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, and it remains a challenge for cardiac surgeons despite advances in medicine. A number of studies have been performed to examine various parameters to predict which patients will develop POAF. The present study was performed to investigate the roles of epicardial adipose tissue (EAT) volume and red blood cell distribution width (RDW) as predictors of POAF.

The medical records of 350 patients undergoing coronary artery bypass grafting in one or more vessels at the Tertiary Cardiac Center, Cardiovascular Surgery Department, Mevlana (Rumi) University Private Hospital (Konya, Turkey), were screened between December 2011 and May 2015. The study population consisted of 149 patients fulfilling the inclusion criteria and undergoing a preoperative evaluation by computed chest tomography. All patient demographics and laboratory parameters were obtained from medical records.

Age, postoperative RDW, and tomography variables, including the left atrial (LA) volume, LA diameters, and EAT volume, were significantly higher while the hemoglobin level and hematocrit were significantly lower in patients developing atrial fibrillation after cardiopulmonary bypass. A logistic multivariate regression analysis was performed on age, postoperative RDW, and tomography variables, including LA volume, LA diameters and EAT volume. Only age (OR 1.0731, 95% CI 1.012–1.138; p = 0.018) was an independent predictor of the development of POAF.

Although the EAT volume was high in patients developing atrial fibrillation after surgery, age was the only significant predictor of POAF on multivariate analysis. Additional studies regarding the predictive roles of epicardial fat and RDW in POAF are needed.

Hakala T, Hedman A. Predicting the risk of atrial fibrillation after coronary artery bypass surgery. Scand Cardiovasc J. 2003 Dec;37(6):309-15. PubMed PMID: 14668179. https://doi.org/10.1080/140174....
Echahidi N, Pibarot P, O'Hara G, Mathieu P. Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery. J Am Coll Cardiol. 2008 Feb 26;51(8):793-801. PubMed PMID: 18294562. https://doi.org/10.1016/j.jacc....
LaPar DJ, Speir AM, Crosby IK, Fonner E, Jr., Brown M, Rich JB, et al. Postoperative atrial fibrillation significantly increases mortality, hospital readmission, and hospital costs. Ann Thorac Surg. 2014 Aug;98(2):527-33; discussion 33. PubMed PMID: 25087786. https://doi.org/10.1016/j.atho....
Yadava M, Hughey AB, Crawford TC. Postoperative atrial fibrillation: incidence, mechanisms, and clinical correlates. Cardiol Clin. 2014 Nov;32(4):627-36. PubMed PMID: 25443241. https://doi.org/10.1016/j.ccl.....
Jakubova M, Mitro P, Stancak B, Sabol F, Kolesar A, Cisarik P, et al. The occurrence of postoperative atrial fibrillation according to different surgical settings in cardiac surgery patients. Interact Cardiovasc Thorac Surg. 2012 Dec;15(6):1007-12. PubMed PMID: 22927177. PMCID: 3501296. https://doi.org/10.1093/icvts/....
Anselmi A, Possati G, Gaudino M. Postoperative inflammatory reaction and atrial fibrillation: simple correlation or causation? Ann Thorac Surg. 2009 Jul;88(1):326-33. PubMed PMID: 19559266. https://doi.org/10.1016/j.atho....
Zakkar M, Ascione R, James AF, Angelini GD, Suleiman MS. Inflammation, oxidative stress and postoperative atrial fibrillation in cardiac surgery. Pharmacol Ther. 2015 Oct;154:13-20. PubMed PMID: 26116810. https://doi.org/10.1016/j.phar....
Yener AÜ, Bekler A, Özkan TA, Erbaş M, Özcan S, Kurt T, et al. Epicardial Adipose Tissue: A Marker of Atrial Fibrillation After Coronary Artery Bypass Graft Surgery. Acta Med Anatol. 2014;2(4):127-32. https://doi.org/10.15824/actam....
Drossos G, Koutsogiannidis CP, Ananiadou O, Kapsas G, Ampatzidou F, Madesis A, et al. Pericardial fat is strongly associated with atrial fibrillation after coronary artery bypass graft surgerydagger. Eur J Cardiothorac Surg. 2014 Dec;46(6):1014-20. PubMed PMID: 24652814. https://doi.org/10.1093/ejcts/....
Ertas G, Aydin C, Sonmez O, Erdogan E, Turfan M, Tasal A, et al. Red cell distribution width predicts new-onset atrial fibrillation after coronary artery bypass grafting. Scand Cardiovasc J. 2013 Jun;47(3):132-5. PubMed PMID: 23035619. https://doi.org/10.3109/140174....
Korantzopoulos P, Sontis N, Liu T, Chlapoutakis S, Sismanidis S, Siminelakis S, et al. Association between red blood cell distribution width and postoperative atrial fibrillation after cardiac surgery: A pilot observational study. Int J Cardiol. 2015 Apr 15;185:19-21. PubMed PMID: 25777283. https://doi.org/10.1016/j.ijca....
Tinica G, Mocanu V, Zugun-Eloae F, Butcovan D. Clinical and histological predictive risk factors of atrial fibrillation in patients undergoing open-heart surgery. Exp Ther Med. 2015 Dec;10(6):2299-304. PubMed PMID: 26668632. PMCID: Pmc4665681. Epub 2015/12/17. Eng. https://doi.org/10.3892/etm.20....
Nakai T, Lee RJ, Schiller NB, Bellows WH, Dzankic S, Reeves J, 3rd, et al. The relative importance of left atrial function versus dimension in predicting atrial fibrillation after coronary artery bypass graft surgery. Am Heart J. 2002 Jan;143(1):181-6. PubMed PMID: 11773931. https://doi.org/10.1067/mhj.20....
Al Chekakie MO, Welles CC, Metoyer R, Ibrahim A, Shapira AR, Cytron J, et al. Pericardial fat is independently associated with human atrial fibrillation. J Am Coll Cardiol. 2010 Aug 31;56(10):784-8. PubMed PMID: 20797492. https://doi.org/10.1016/j.jacc....
Wong CX, Abed HS, Molaee P, Nelson AJ, Brooks AG, Sharma G, et al. Pericardial fat is associated with atrial fibrillation severity and ablation outcome. J Am Coll Cardiol. 2011 Apr 26;57(17):1745-51. PubMed PMID: 21511110. https://doi.org/10.1016/j.jacc....
Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M, et al. Relation between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People with Coronary Disease. Circulation. 2008 Jan 15;117(2):163-8. PubMed PMID: 18172029. https://doi.org/10.1161/CIRCUL....
Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007 Jul 3;50(1):40-7. PubMed PMID: 17601544. https://doi.org/10.1016/j.jacc....
van Kimmenade RR, Mohammed AA, Uthamalingam S, van der Meer P, Felker GM, Januzzi JL, Jr. Red blood cell distribution width and 1-year mortality in acute heart failure. Eur J Heart Fail. 2010 Feb;12(2):129-36. PubMed PMID: 20026456. https://doi.org/10.1093/eurjhf....
Alameddine AK, Visintainer P, Alimov VK, Rousou JA. Blood transfusion and the risk of atrial fibrillation after cardiac surgery. J Card Surg. 2014 Sep;29(5):593-9. PubMed PMID: 24965706. https://doi.org/10.1111/jocs.1....
Tran DT, Perry JJ, Dupuis JY, Elmestekawy E, Wells GA. Predicting New-Onset Postoperative Atrial Fibrillation in Cardiac Surgery Patients. J Cardiothorac Vasc Anesth. 2015 Oct;29(5):1117-26. PubMed PMID: 25857671. https://doi.org/10.1053/j.jvca....
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