Postoperative Atrial Fibrillation Predicted by Plasma Catecholamines
Assessment of plasma catecholamines may be a low-cost method for predicting postoperative AF.
HealthDay News — Assessment of plasma catecholamines on the morning of surgery can predict the likelihood of postoperative atrial fibrillation (AF) for patients undergoing elective cardiac surgery, according to a study published online in the Journal of the American College of Cardiology.
Ethan J. Anderson, PhD, from the University of Iowa in Iowa City, and colleagues examined the association of plasma catecholamines and monoamine oxidase-B with postoperative AF in patients undergoing elective cardiac surgery. A total of 324 patients undergoing non-emergent coronary artery bypass graft and/or aortic valve surgery with cardiopulmonary bypass were included; blood samples were obtained before administration of anesthesia on the morning of surgery.
The researchers found that norepinephrine (NE) and epinephrine levels in the fourth quartile were positively associated with postoperative AF (P =.0006 and .047, respectively), while there was an inverse correlation for dopamine (DA) levels in the fourth quartile with POAF (P =.0034). The composite preoperative (adrenergic) plasma marker (Q4NE+ vs Q4DA−) was associated with a 4-fold increased occurrence of postoperative AF after adjustment for age, heart failure, and history of atrial fibrillation (adjusted P =.0001). There was no correlation between plasma monoamine oxidase-B and postoperative AF.
"This information provides evidence that assessment of plasma catecholamines may be an easy-to-implement, low-cost method to predict which patients are likely to develop [postoperative] AF," the authors wrote. "More investigation is needed to validate our results in a multi-centric setting."
Anderson EJ, Efird JT, Kiser AC, et al. Plasma catecholamine levels on the morning of surgery predict post-operative atrial fibrillation [published online April 26, 2017]. JACC Clin Electrophysiol. doi:10.1016/j.jacep.2017.01.014