Circulating cardiac biomarkers and postoperative atrial fibrillation in the OPERA trial. (7th January 2015)

• Record Type: Journal Article
• Authors: 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.; Tognoni, Gianni; Mozaffarian, Dariush; Latini, Roberto; the OPERA Investigators
• Is Part Of: European journal of clinical investigation. Volume 45:Number 2(2015:Feb.)
• Page Start: 170
• Page End: 178
• Publication Date: 2015-01-07
• Subjects: Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.12393
• Languages: English
• ISSNs: 0014-2972

Abstract

<abstract abstract-type="main" id="eci12393-abs-0001"> <title>Abstract</title> <sec id="eci12393-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="eci12393-sec-0002" sec-type="section"> <title>Methods</title> <p>Plasma concentrations of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) and high‐sensitivity cardiac troponin T (hs‐cTnT) 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 Omega‐3 Fatty Acids for Prevention of Post‐Operative Atrial Fibrillation trial (OPERA). The primary endpoint was incident POAF lasting ≥ 30 s, centrally adjudicated and confirmed electrocardiographically.</p> </sec> <sec id="eci12393-sec-0003" sec-type="section"> <title>Results</title> <p>Higher levels of NT‐proBNP and hs‐cTnT before surgery were associated with older age, renal or cardiac dysfunction and EuroSCORE. NT‐proBNP peaked on postoperative day 2 (2172 [1238–3758] ng/L, median [Q1–Q3]), while hs‐cTnT peaked at the end of surgery (373 [188–660] ng/L). Fish oil supplementation did not alter the time course of the cardiac biomarkers (<italic>P</italic> > 0·05). Concentrations of NT‐proBNP or hs‐cTnT, 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.</p> </sec> <sec id="eci12393-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Among patients undergoing cardiac surgery, NT‐proBNP and hs‐cTnT are related to clinical and surgical characteristics, have different perioperative time courses but are not independently associated with risk of POAF.</p> </sec> </abstract>