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Plasma Catecholamine Levels on the Morning of Surgery Predict Post-Operative Atrial Fibrillation.
Anderson, Ethan J; Efird, Jimmy T; Kiser, Andy C; Crane, Patricia B; O'Neal, Wesley T; Ferguson, T Bruce; Alwair, Hazaim; Carter, Kendal; Williams, J Mark; Gehi, Anil K; Kypson, Alan P.
Afiliação
  • Anderson EJ; Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa.
  • Efird JT; Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
  • Kiser AC; Center for Epidemiology and Outcomes Research, East Carolina Heart Institute, Greenville, North Carolina.
  • Crane PB; Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
  • O'Neal WT; Office of the Dean of Research, College of Nursing, East Carolina University, Greenville, North Carolina.
  • Ferguson TB; Center for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
  • Alwair H; Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
  • Carter K; Office of the Dean of Research, College of Nursing, East Carolina University, Greenville, North Carolina.
  • Williams JM; Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia.
  • Gehi AK; Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
  • Kypson AP; Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
JACC Clin Electrophysiol ; 3(12): 1456-1465, 2017 12 11.
Article em En | MEDLINE | ID: mdl-29430523
OBJECTIVES: This study sought to determine whether plasma catecholamines and monoamine oxidase-B (MOA-B) are associated with post-operative atrial fibrillation (POAF) in patients undergoing elective cardiac surgery. BACKGROUND: Although intra- and post-operative adrenergic tone has been demonstrated to be an causative factor for POAF, the role and association of pre-operative plasma catecholamines remains unclear. METHODS: Prior to administration of anesthesia on the morning of surgery, blood samples were obtained from 324 patients undergoing nonemergent coronary artery bypass graft and/or aortic valve surgery with cardiopulmonary bypass at East Carolina Heart Institute. The concentrations of norepinephrine (NE), dopamine (DA), epinephrine (EPI), and enzyme MAO-B were assessed in platelet-rich plasma. A log-binomial regression model was used to determine the association between quartiles of these variables and POAF. RESULTS: Levels of NE (p = 0.0006) and EPI (p = 0.047) in the 4th quartile [Formula: see text] were positively associated with POAF, whereas DA (p = 0.0034) levels in the 4th quartile [Formula: see text] were inversely associated with POAF. Adjusting for age, heart failure (HF), and history of atrial fibrillation, the composite pre-operative (adrenergic) plasma marker [Formula: see text] was associated with a 4-fold increased occurrence of POAF (adjusted p = 0.0001). No association between plasma MAO-B and POAF was observed. CONCLUSIONS: Our results suggest that pre-operative adrenergic tone is an important factor underlying POAF. This information provides evidence that assessment of plasma catecholamines may be a low-cost method that is easy to implement for predicting which patients are likely to develop POAF. More investigation in a multicentric setting is needed to validate our results.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article