Increased preoperative white blood cell count predicts postoperative atrial fibrillation after coronary artery bypass surgery Journal Article
| Authors: | Fontes, M. L.; Amar, D.; Kulak, A.; Koval, K.; Zhang, H.; Shi, W.; Thaler, H. |
| Article Title: | Increased preoperative white blood cell count predicts postoperative atrial fibrillation after coronary artery bypass surgery |
| Abstract: | Objective: To better understand the relationship between humoral and cellular markers of inflammation and postoperative atrial fibrillation (AF). Design: A prospective and descriptive study. Setting: Academic institution. Participants: Sixty adult patients ≥60 years of age presenting for elective coronary artery bypass surgery with cardiopulmonary bypass (CPB). Interventions: None. Measurements and Main Results: With institutional review board approval, serial measurements for high sensitivity C-reactive protein (CRP) and white blood cell count (WBC) were performed before the induction of anesthesia, on arrival in the intensive care unit, and on the mornings of postoperative days 1 and 2. Continuous telemetry and daily 12-lead electrocardiographs were used to confirm new-onset AF. AF occurred in 17 of 60 (28%; 95% confidence interval, 17%-41%) patients. A history of preoperative myocardial infarction was more frequent among patients who developed AF (p = 0.049). Patients with or without AF did not differ in CRP values at any of the 4 study time points (p = 0.61 to p = 0.81). Preoperative WBC values were higher for patients who developed AF, and, according to stepwise logistic regression, it was the sole independent predictor of postoperative AF (odds ratio = 6.7; 95% confidence interval, 1.6-29.0; p = 0.01). A 2-fold higher preoperative WBC was associated with a nearly 7-fold higher risk of developing AF, and WBC >7 × 10<sup>9</sup>/L was associated with a nearly 4-fold higher risk of AF (odds ratio = 3.8, p = 0.03). Conclusion: In this cohort of patients undergoing CABG surgery, preoperative leukocytosis was a significant predictor of AF independent of CRP. © 2009 Elsevier Inc. All rights reserved. |
| Keywords: | aged; middle aged; major clinical study; c reactive protein; biological markers; cohort studies; inflammation; odds ratio; c-reactive protein; prediction; risk assessment; postoperative complication; postoperative complications; coronary artery bypass; preoperative period; leukocyte count; postoperative atrial fibrillation, c-reactive protein, coronary artery bypass graft surgery, cardiopulmonary bypass, white blood cell count; coronary artery bypass surgery; electrocardiography; heart atrium fibrillation; leukocytosis; telemetry; atrial fibrillation |
| Journal Title: | Journal of Cardiothoracic and Vascular Anesthesia |
| Volume: | 23 |
| Issue: | 4 |
| ISSN: | 1053-0770 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2009-08-01 |
| Start Page: | 484 |
| End Page: | 487 |
| Language: | English |
| DOI: | 10.1053/j.jvca.2009.01.030 |
| PUBMED: | 19362015 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "CODEN: JCVAE" - "Source: Scopus" |
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