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 &gt;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
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "CODEN: JCVAE" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Weiji Shi
    121 Shi
  2. Howard T Thaler
    240 Thaler
  3. Hao Zhang
    54 Zhang