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Circulating cardiac biomarkers and postoperative atrial fibrillation in the OPERA trial
Author(s) -
Masson Serge,
Wu Jason H. Y.,
Simon Caterina,
Barlera Simona,
Marchioli Roberto,
Mariani Javier,
Macchia Alejandro,
Lombardi Federico,
Vago Tarcisio,
Aleksova Aneta,
Dreas Lorella,
Favaloro Roberto R.,
Hershson Alejandro R.,
Puskas John D.,
Dozza Luca,
Silletta Maria G.,
Togi Gianni,
Mozaffarian Dariush,
Latini Roberto
Publication year - 2015
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12393
Subject(s) - medicine , atrial fibrillation , cardiac surgery , perioperative , troponin t , cardiology , clinical endpoint , natriuretic peptide , randomized controlled trial , heart failure , surgery , myocardial infarction
Background Postoperative 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 pro‐ B ‐type natriuretic peptide ( NT ‐pro BNP ) and high‐sensitivity cardiac troponin T (hs‐c T n T ) were measured at enrolment, on the morning of cardiac surgery, at end surgery, and 2 days postsurgery in 562 patients undergoing cardiac surgery, randomized to perioperative supplementation with oral fish oil or placebo in the O mega‐3 F atty A cids for P revention of P ost‐ O perative A trial F ibrillation trial ( OPERA ). The primary endpoint was incident POAF lasting ≥ 30 s, centrally adjudicated and confirmed electrocardiographically. Results Higher levels of NT ‐pro BNP and hs‐c T n T before surgery were associated with older age, renal or cardiac dysfunction and Euro SCORE . NT ‐pro BNP peaked on postoperative day 2 (2172 [1238–3758] ng/L, median [Q1–Q3]), while hs‐c T n T peaked at the end of surgery (373 [188–660] ng/L). Fish oil supplementation did not alter the time course of the cardiac biomarkers ( P > 0·05). Concentrations of NT ‐pro BNP or hs‐c T n T , on the morning of surgery, or changes in their level between morning of surgery and postsurgery, were not significantly associated with POAF after adjustment for clinical and surgical characteristics. Conclusion Among patients undergoing cardiac surgery, NT ‐pro BNP and hs‐c T n T are related to clinical and surgical characteristics, have different perioperative time courses but are not independently associated with risk of POAF .