Effect of Alpha-Lipoic Acid on Atrial Fibrillation after Open Heart Surgery

Background: Postoperative atrial fibrillation (POAF) is associated with increased morbidity and mortality, and an inflammatory process is involved in its pathogenesis. We aimed to study the possible effect of alpha-lipoic acid (ALA) as an antioxidant on atrial fibrillation after cardiac surgery. Methods: The study included ninety patients who underwent cardiac surgery, either valvular or coronary artery bypass grafting using cardiopulmonary bypass, and were randomized into two groups: Control and ALA groups. Blood samples were obtained to measure preoperative and postoperative levels of malondialdehyde (MDA), glutathione, C-reactive protein (CRP) and interleukin-6 (IL-6). The patients were monitored for the occurrence of atrial fibrillation until the day of discharge. Results: POAF occurred in 33% in the control group versus 11% in the ALA group (p=0.011).  When compared to the control group, ALA significantly decreased the postoperative levels of MDA (4.78±0.91 vs. 5.36±1.03 nmol/ml; p= 0.006) CRP (19.44±3.14 vs. 26.56±6.29 mg/dl; p <0.001) and IL-6 (22.25±2.2 vs. 25.37±2.5 pg/ml; p< 0.001) while glutathione level increased significantly in patients who received ALA (26.4±4.59 vs. 23.44±5.11 mg/l; p= 0.005). Conclusion: ALA may help in the prevention of atrial fibrillation following cardiac surgery through exerting antioxidant and anti-inflammatory effects.