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Neopterin as a predictive biomarker of postoperative atrial fibrillation following coronary artery bypass grafting


- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
- Department of Statistical Analyses and Computed Sciences, Poznan University of Medical Sciences, Poznań, Poland
- Department of Clinical Pharmacology, Poznan University of Medical Sciences, Poznań, Poland
open access
Abstract
Background: The pathophysiology of postoperative atrial fibrillation (POAF) is multifactorial. Inflammation and increased oxidative stress play a significant role in POAF development. Neopterin, a biomarker of cellular immune response that enhances oxidative stress and increases the cytotoxic potential of activated macrophages and dendritic cells, was recently found as an independent predictive biomarker of non-operative atrial fibrillation. However, as far as we know, neopterin has never been investigated in POAF.
Aims: The study aimed to assess neopterin concentration as a prognostic biomarker of POAF following coronary artery bypass grafting (CABG).
Methods: One hundred one patients (80.2% males, 85% off-pump, 15% on-pump) were included. Blood samples were taken from patients for analysis of serum neopterin and high-sensitive C-reactive protein (hs-CRP) at three time points: (1) before operation (NP0); (2) on the first day after operation (NP1); and (3) between the fifth and eighth day after the procedure (NP5–8). All factors (preoperative, echocardiographic, and surgical), significant in univariate analysis, were included in a multivariable logistic regression analysis.
Results: POAF occurred in 30 patients (30%). In the analyzed multivariable logistic regression models, the independent predictors of POAF occurrence were: higher NP0 concentration (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.02–1.38 for continuous and OR, 3.75; 95% CI, 1.39–10.1 for NP0 cut-off >8.7 nmol/l), higher body mass index (OR, 1.15; 95% CI 1.02–1.29), history of pulmonary disease (OR, 6.72; 95% CI 1.57–28), increased diastolic thickness of the interventricular septum (OR, 1.45; 95% CI, 1.14–1.83), and duration of operation (OR, 1.01; 95% CI, 1.03–1.36).
Conclusions: We found that elevated neopterin concentration before CABG may be a predictive biomarker of POAF.
Abstract
Background: The pathophysiology of postoperative atrial fibrillation (POAF) is multifactorial. Inflammation and increased oxidative stress play a significant role in POAF development. Neopterin, a biomarker of cellular immune response that enhances oxidative stress and increases the cytotoxic potential of activated macrophages and dendritic cells, was recently found as an independent predictive biomarker of non-operative atrial fibrillation. However, as far as we know, neopterin has never been investigated in POAF.
Aims: The study aimed to assess neopterin concentration as a prognostic biomarker of POAF following coronary artery bypass grafting (CABG).
Methods: One hundred one patients (80.2% males, 85% off-pump, 15% on-pump) were included. Blood samples were taken from patients for analysis of serum neopterin and high-sensitive C-reactive protein (hs-CRP) at three time points: (1) before operation (NP0); (2) on the first day after operation (NP1); and (3) between the fifth and eighth day after the procedure (NP5–8). All factors (preoperative, echocardiographic, and surgical), significant in univariate analysis, were included in a multivariable logistic regression analysis.
Results: POAF occurred in 30 patients (30%). In the analyzed multivariable logistic regression models, the independent predictors of POAF occurrence were: higher NP0 concentration (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.02–1.38 for continuous and OR, 3.75; 95% CI, 1.39–10.1 for NP0 cut-off >8.7 nmol/l), higher body mass index (OR, 1.15; 95% CI 1.02–1.29), history of pulmonary disease (OR, 6.72; 95% CI 1.57–28), increased diastolic thickness of the interventricular septum (OR, 1.45; 95% CI, 1.14–1.83), and duration of operation (OR, 1.01; 95% CI, 1.03–1.36).
Conclusions: We found that elevated neopterin concentration before CABG may be a predictive biomarker of POAF.
Keywords
coronary artery bypass grafting, inflammatory biomarker, neopterin, postoperative atrial fibrillation




Title
Neopterin as a predictive biomarker of postoperative atrial fibrillation following coronary artery bypass grafting
Journal
Kardiologia Polska (Polish Heart Journal)
Issue
Article type
Original article
Pages
902-910
Published online
2022-06-10
Page views
1224
Article views/downloads
185
DOI
10.33963/KP.a2022.0143
Pubmed
Bibliographic record
Kardiol Pol 2022;80(9):902-910.
Keywords
coronary artery bypass grafting
inflammatory biomarker
neopterin
postoperative atrial fibrillation
Authors
Anna Smukowska-Gorynia
Bartłomiej Perek
Marek Jemielity
Anna Olasińska-Wiśniewska
Justyna Marcinkowska
Sebastian Stefaniak
Artur Cieślewicz
Sylwia Iwańczyk
Maciej Lesiak
Tatiana Mularek-Kubzdela


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