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

Anna Smukowska-Gorynia1, Bartłomiej Perek2, Marek Jemielity2, Anna Olasińska-Wiśniewska1, Justyna Marcinkowska3, Sebastian Stefaniak2, Artur Cieślewicz4, Sylwia Iwańczyk1, Maciej Lesiak1, Tatiana Mularek-Kubzdela1
DOI: 10.33963/KP.a2022.0143
·
Pubmed: 35698968
Affiliations
  1. 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
  2. Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
  3. Department of Statistical Analyses and Computed Sciences, Poznan University of Medical Sciences, Poznań, Poland
  4. Department of Clinical Pharmacology, Poznan University of Medical Sciences, Poznań, Poland

open access

Online first
Original article
Published online: 2022-06-10

Abstract

BACKGROUND: 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.

AIM: The study aimed to assess neopterin concentration as a prognostic biomarker of POAF following coronary artery bypass grafting (CABG).

METHODS: 101 (80.2% males, 85% off-pump, 15% on-pump) patients were included. Blood samples were taken from patients at three-time points: (1) before operation (NP0); (2) on the first day after the operation (NP1); and (3) between the fifth and eighth day after the procedure (NP5-8) for analysis of serum neopterin and high-sensitive C-reactive protein (hs-CRP). 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 nM/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 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: 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.

AIM: The study aimed to assess neopterin concentration as a prognostic biomarker of POAF following coronary artery bypass grafting (CABG).

METHODS: 101 (80.2% males, 85% off-pump, 15% on-pump) patients were included. Blood samples were taken from patients at three-time points: (1) before operation (NP0); (2) on the first day after the operation (NP1); and (3) between the fifth and eighth day after the procedure (NP5-8) for analysis of serum neopterin and high-sensitive C-reactive protein (hs-CRP). 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 nM/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 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.

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Keywords

coronary artery bypass grafting, inflammatory biomarker, neopterin, postoperative atrial fibrillation

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Title

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

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2022-06-10

Page views

98

Article views/downloads

46

DOI

10.33963/KP.a2022.0143

Pubmed

35698968

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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