Abstract 12364: Circulating Cardiac and Inflammatory Biomarkers to Predict Post-Operative Atrial Fibrillation in the OPERA Trial
Objectives: Post-operative atrial fibrillation (POAF) is a common complication after cardiac surgery and predicts increased morbidity and mortality. Identification of patients at high risk of POAF with the help of circulating biomarkers may enable early preventive treatment but data are limited, especially in contemporary surgical patients.
Methods: Plasma concentrations of N-terminal probrain natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin T (hs-cTnT) and C-reactive protein (hsCRP) were measured at enrollment, on the morning of cardiac surgery, at end-surgery, and 2 days post-surgery in 562 patients undergoing cardiac surgery, randomized to perioperative supplementation with oral fish oil or placebo in the international clinical trial Omega-3 Fatty Acids for Prevention of Post-Operative Atrial Fibrillation trial (OPERA). The primary endpoint was incident POAF lasting ≥ 30 seconds, centrally adjudicated and confirmed electrocardiographically.
Results: Higher levels of NT-proBNP and hs-cTnT before surgery were associated with older age, renal or cardiac dysfunction and higher EuroSCORE, while hsCRP correlated positively with BMI. NT-proBNP (2172 [1238-3758] ng/L) and hsCRP (118 [75-165] mg/L) peaked on post-operative day 2, while hs-cTnT peaked at the end of surgery (373 [188-660] ng/L). Fish oil supplementation did not alter the time course of the cardiac or inflammatory biomarkers. Concentrations of the 3 biomarkers, on the morning of surgery, or changes in their level between morning of surgery and post-surgery, were not significantly associated with POAF after adjustment for clinical and surgical characteristics.
Conclusions: Among patients undergoing cardiac surgery, cardiac markers are related to clinical and surgical characteristics, have different perioperative time courses but do not help in predicting the risk of POAF.
Author Disclosures: S. Masson: Other Research Support; Modest; Reagents provided in kind by Roche Diagnostics. Consultant/Advisory Board; Modest; Roche Diagnostics. J.H. Wu: None. S. Barlera: None. L. Bani: None. R. Marchioli: None. A. Macchia: None. T. Vago: None. J.D. Puskas: None. R. Favaloro: None. A. Hershson: None. R. Sinatra: None. G. Melina: None. L. Nicolosi: None. L. Dreas: None. J. VanderWoude: None. G. Tognoni: None. D. Mozaffarian: None. R. Latini: Research Grant; Modest; Roche Diagnostics. Consultant/Advisory Board; Modest; Roche Diagnostics.
- © 2014 by American Heart Association, Inc.