Abstract 16178: Myeloperoxidase in Pericardial Drainage is a More Specific Predictor of Atrial Fibrillation in Patients Following Isolated Coronary Artery Bypass Grafting
Purpose: Evidence shows that systemically and locally increased myeloperoxidase (MPO) availability is associated with AF, while their roles and predictive values on the occurrence of AF after CABG (POAF) are largely unknown. This study examined the association of MPO levels in pericardial drainage (PD) and blood with the occurrence of POAF and their predictive values.
Method: The sample in this prospective cohort study was 137 eligible patients undergoing first time elective isolated CABG. The main endpoint was the occurrence of first AF lasting ≥ 5min. The patients were grouped as either POAF or sinus rhythm (SR) according to their postoperative rhythm, which was continuously monitored for the first 7 postoperative days. MPO levels in PD and blood were measured by ELISA at the 6th (T6), 12th (T12), and 18th hour (T18) postoperatively. Pre-anesthesia (T0) blood MPO level was also measured. Two-factor ANOVA for repeated measures was used to test the trends of MPO changes. Logistic regression and ROC curves were used to determine the predictive values of MPO.
Results: Overall, 45 patients (32.85%) developed POAF. The trends of MPO level changes over time in both PD and blood in the POAF group differed significantly from patients in the SR group. In the POAF group, PD MPO levels over time were 207-543 times higher than in blood but 210-324 times higher in the SR groups (p = 0.038). Logistic regression showed that both MPO levels in PD at T6 and in blood at T0 were independent predictors of POAF even after adjusting for age and left atrial diameter. The PD MPO level of ≥ 267,01.08ng/ml at T6, and blood MPO level ≥ 26.66ng/ml at T0 were strong predictors of POAF (OR 6.754, 95% CI 2.431-18.770; and OR 4.899, 95% CI 1.962-12.230, respectively) with sensitivity of 51% and 71%, specificity of 89% and 72%, respectively.
Conclusions: Both MPO levels in PD at T6 and in blood at T0 are strong predictors of POAF, but PD MPO level of ≥ 26,701ng/ml at T6 has a higher specificity in predicting the occurrence of POAF.
- © 2013 by American Heart Association, Inc.