The use of monocyte to HDL ratio to predict postoperative atrial fibrillation after aortocoronary bypass graft surgery

Abstract

INTRODUCTION[|]Postoperative atrial fibrillation (POAF) is a frequent and serious complication after aorto-coronary bypass graft (ACBG) surgery which unfortunately increases morbidity and mortality. Postoperative stroke, hemodynamic instability, renal failure, infection, inotropic agent and coronary unit need are complications caused by POAF. Inflammation and oxidative stress are among several mechanisms contributing to the pathogenesis of POAF. Monocyte to HDL ratio (M/H ratio) is a newly defined parameter of both inflammation and oxidative stress. In this study we investigated M/H ratio in predicting POAF after ACBG surgery.[¤]METHODS[|]Total number of 311 patients who underwent ACBG surgery were included in our study. Blood samples were obtained from the patients after 12 hours of fasting for analysis of routine biochemistry and lipid panel in the morning of ACBG surgery. Patients were monitored for the occurrence of POAF continuously through hospitalization. [¤]RESULTS[|]POAF was demonstrated in 71 patients after ACBG operation. M/H ratio was significantly higher in POAF+ group compared to POAF – group (p< 0.001). Median age of POAF (+) patients is 62.0+-10.1 which was significantly higher than POAF (-) patients. Other atrial fibrillation risk factors such as hypertension, diabetes mellitus, smoking or alcohol consumption were similar between groups. Potassium level was statistically lower in POAF+ group compared to POAF- group. (p= 0,01)[¤]DISCUSSION AND CONCLUSION[|]M/H ratio is an indicator of inflammation and oxidative stress which both plays an important role in the pathogenesis of atrial fibrillation. M/H ratio was found be statistically higher in POAF + patients compared to POAF – patients.[¤]

Keywords

• atrial fibrillation
• postoperative atrial fibrillation
• monocyte to high density lipoprotein ratio