This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gaudino, M. Articles by Possati, G. Search for Related Content PubMed PubMed Citation Articles by Gaudino, M. Articles by Possati, G.

(Circulation. 2003;108:II-195.)
© 2003 American Heart Association, Inc.

Arrythmia Surgery

The -174G/C Interleukin-6 Polymorphism Influences Postoperative Interleukin-6 Levels and Postoperative Atrial Fibrillation. Is Atrial Fibrillation an Inflammatory Complication?

Mario Gaudino, MD; Felicita Andreotti, MD; Roberto Zamparelli, MD; Augusto Di Castelnuovo, MS; Giuseppe Nasso, MD; Francesco Burzotta, MD; Licia Iacoviello, MD, PhD; Maria Benedetta Donati, MD; Rocco Schiavello, MD; Attilio Maseri, MD; Gianfederico Possati, MD

From the Department of Cardiac Surgery, Cardiac Anaesthesiology, and Cardiology, Catholic University, Rome, Italy; Angela Valenti Laboratory of Genetic and Environmental Risk Factors for Thrombotic Disease, Department of Vascular Medicine and Pharmacology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy, Research Laboratories. Center for High Technology Research and Education in Biomedical Sciences. Catholic University, Campobasso, Italy.

Correspondence to Mario Gaudino, MD, Divisione di Cardiochirurgia, Policlinico Universitario A. Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy. Fax 39-178-22-00-00-88-564; E-mail mgaudino{at}tiscalinet.it

Background— It has been suggested that inflammation can have a role in the development of atrial arrhythmias after cardiac surgery and that a genetic predisposition to develop postoperative complications exists. This study was conceived to verify if a potential genetic modulator of the systemic inflammatory reaction to cardiopulmonary bypass (the -174 G/C polymorphism of the promoter of the Interleukin-6 gene) has a role in the pathogenesis of postoperative atrial fibrillation (AF).

Patients and Results— In 110 primary isolated coronary artery bypass patients the -174G/C Interleukin-6 promoter gene variant was determined. Interleukin-6, fibrinogen and C-reactive protein plasma levels were determined preoperatively, 24, 48, and 72 hours after surgery and at discharge. Heart rate and rhythm were continuously monitored for the first 36 to 48 hours; daily 12-lead electrocardiograms were performed thereafter until discharge. GG, CT, and CC genotypes were found in 62, 38, and 10 patients, respectively. Multivariate analysis (which included genotype, age, sex, and classical risk factors for AF) identified the GG genotype as the only independent predictor of postoperative AF. The latter occurred in 33.9% of GG versus 10.4% of non-GG patients (hazard ratio 3.25, 95%CI 1.23 to 8.62). AF patients had higher blood levels of Interleukin-6 and fibrinogen after surgery (P<0.001 for difference between the area under the curve).

Conclusion— The -174G/C Interleukin-6 promoter gene variant appears to modulate the inflammatory response to surgery and to influence the development of postoperative AF. These data suggest an inflammatory component of postoperative atrial arrhythmias and a genetic predisposition to this complication.

Key Words: aortocoronary bypass • atrial fibrillation • genetics

This article has been cited by other articles:

				M. V. Podgoreanu and J. P. Mathew Prophylaxis Against Postoperative Atrial Fibrillation: Current Progress and Future Directions JAMA, December 28, 2005; 294(24): 3140 - 3142. [Full Text] [PDF]