Circulating cardiac biomarkers and postoperative atrial fibrillation in the OPERA trial

Serge Masson, Jason H Y Wu, Caterina Simon, Simona Barlera, Roberto Marchioli, Javier Mariani, Alejandro Macchia, Federico Lombardi, Tarcisio Vago, Aneta Aleksova, Lorella Dreas, Roberto R. Favaloro, Alejandro R. Hershson, John D. Puskas, Luca Dozza, Maria G. Silletta, Gianni Tognoni, Dariush Mozaffarian, Roberto Latini

Research output: Contribution to journalArticle

Abstract

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-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. Results: 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 (P > 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. Conclusion: 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.

Original languageEnglish
Pages (from-to)170-178
Number of pages9
JournalEuropean Journal of Clinical Investigation
Volume45
Issue number2
DOIs
Publication statusPublished - Feb 1 2015

Keywords

  • Cardiac surgery
  • Fish oil
  • High-sensitive cardiac troponin
  • N-terminal pro-B-type natriuretic peptide
  • Postoperative atrial fibrillation

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Biochemistry
  • Biochemistry

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  • Cite this

    Masson, S., Wu, J. H. Y., Simon, C., Barlera, S., Marchioli, R., Mariani, J., Macchia, A., Lombardi, F., Vago, T., Aleksova, A., Dreas, L., Favaloro, R. R., Hershson, A. R., Puskas, J. D., Dozza, L., Silletta, M. G., Tognoni, G., Mozaffarian, D., & Latini, R. (2015). Circulating cardiac biomarkers and postoperative atrial fibrillation in the OPERA trial. European Journal of Clinical Investigation, 45(2), 170-178. https://doi.org/10.1111/eci.12393