- Title
- Plasma catecholamine levels on the morning of surgery predict post-operative atrial fibrillation
- Creator
- Anderson, Ethan J.; Efird, Jimmy T.; Kypson, Alan P.; Kiser, Andy C.; Crane, Patricia B.; O'Neal, Wesley T.; Ferguson, T. Bruce; Alwair, Hazaim; Carter, Kendal; Williams, J. Mark; Gehi, Anil K.
- Relation
- JACC: Clinical Electrophysiology Vol. 3, Issue 12, p. 1456-1465
- Publisher Link
- http://dx.doi.org/10.1016/j.jacep.2017.01.014
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2017
- Description
- Objectives: This study sought to determine whether plasma catecholamines and monoamine oxidase-B (MOA-B) are associated with post-operative atrial fibrillation (POAF) in patients undergoing elective cardiac surgery. Background: Although intra- and post-operative adrenergic tone has been demonstrated to be an causative factor for POAF, the role and association of pre-operative plasma catecholamines remains unclear. Methods: Prior to administration of anesthesia on the morning of surgery, blood samples were obtained from 324 patients undergoing nonemergent coronary artery bypass graft and/or aortic valve surgery with cardiopulmonary bypass at East Carolina Heart Institute. The concentrations of norepinephrine (NE), dopamine (DA), epinephrine (EPI), and enzyme MAO-B were assessed in platelet-rich plasma. A log-binomial regression model was used to determine the association between quartiles of these variables and POAF. Results: Levels of NE (p = 0.0006) and EPI (p = 0.047) in the 4th quartile (Q4+NE) were positively associated with POAF, whereas DA (p = 0.0034) levels in the 4th quartile (Q4+NE) were inversely associated with POAF. Adjusting for age, heart failure (HF), and history of atrial fibrillation, the composite pre-operative (adrenergic) plasma marker (Q4+NE V Q4-DA) was associated with a 4-fold increased occurrence of POAF (adjusted p = 0.0001). No association between plasma MAO-B and POAF was observed. Conclusions: Our results suggest that pre-operative adrenergic tone is an important factor underlying POAF. This information provides evidence that assessment of plasma catecholamines may be a low-cost method that is easy to implement for predicting which patients are likely to develop POAF. More investigation in a multicentric setting is needed to validate our results.
- Subject
- catecholamine; heart surgery; post-operative atrial fibrillation; sympathetic activation
- Identifier
- http://hdl.handle.net/1959.13/1394650
- Identifier
- uon:33745
- Identifier
- ISSN:2405-500X
- Language
- eng
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