C-reactive Protein Linked with Increased AFib Following CABG Surgery

A key marker of inflammation may be associated with the development of post-operative atrial fibrillation (POAF), a common complication that follows coronary artery bypass graft (CABG) surgery, according to a new study.

“Inflammation may be an important factor for the pathogenesis of POAF, and increased preoperative levels of C-reactive protein are associated with the development of POAF,” the authors wrote in their study. “However, the relationship between postoperative C-reactive protein and POAF is less well established.”

The study included more then 6,700 patients undergoing isolated CABG surgery for the first time (data were taken from the Eastern Danish Heart Surgery Database and administrative registries). Patients had no history of AFib and available measurements of C-reactive protein levels at four days post-operation. The authors divided the patients into quartiles based on C-reactive protein level and used multivariable logistic regression analysis to determine the link between the levels and POAF.

C-reactive protein level intervals on day four after the operation for the C-reactive protein groups (from lowest to highest) were ≤90, >90 to ≤127, >127 to ≤175, and >175 mg/L, respectively. Those in the highest C-reactive protein group tended to be older and male compared with those in lower groups. About 35% of those in the highest group developed POAF, compared to 25% in the lowest group. After adjustment, it was observed that those in the highest C-reactive protein group had a higher risk for developing POAF than those in the lowest group (OR-1.31; 95% CI, 1.12 to 1.54).

“Increased postoperative C-reactive protein levels after CABG surgery was associated with the development of POAF,” the authors concluded. The study was published in EP Europace.

OJ Olesen @EmilFosb et al found that
⬆️ post op. CRP levels after #CABG surgery 🔪❤️ was associated with the development of POAF. 💓

CRP mg/L ≤90 had 25% POAF and CRP >175 had 35% giving a HR (95%CI) 1.31 (1.12–1.54)https://t.co/CnpnjpF7Ty#afib #cardiotwitter #Cardiology pic.twitter.com/SmEesxTyRa

— Copenhagen Cardiovascular Research Center (@CopCard) July 6, 2020