Author + information
- Veysel Oktay1,
- Onur Baydar1,
- Ümit Yaşar Sinan1,
- İsmail Polat Canbolat1,
- Gürkan İmre1,
- Okay Abacı1,
- Cüneyt Kocaş1,
- Zerrin Yiğit1,
- Cenk Eray Yıldız2,
- Alican Hatemi2 and
- Ayşem Kaya3
Postoperative atrial fibrillation (POAF) is the most common arrhythmia following coronary artery bypass surgery(CABG). Although pathogenesis of POAF is multifactorial, oxidative stress induced by ischemia-reperfusion injury is a major contributory factor. The vulnerability of myocardial tissue to the oxidative stress is also dependent on the activity of the antioxidant systems. In this trial we aimed to investigate the impact of oxidative stress and antioxidant respond caused by ischemia-reperfusion injury in the course of aortic cross clamp (ACC).
117 patients in sinus rhythm with ischemic heart disease underwent elective coronary artery bypass surgery for myocardial revascularization were enrolled to our study. Oxidative stress indices including total oxidant status (TOS), oxidative stress index (OSI) and total antioxidant capacity (TAC) values were measured before and after removal of ACC. Postoperative atrial fibrillation was detected by analysing the rhythm records of telemetry unit during 96 hours postoperatively.In addition to oxidative stress parameters other factors associated with the development AF postoperatively were evaluated.
During the postoperative follow up, atrial fibrillation was occured in 37 patients and 80 patients were maintained with sinus rhythm. In patients developed POAF, the changes of TOS, TAC and OSI values before and after ACC were significant statistically by comparison to patients maintained with sinus rhythm (Table 1). In multivariate analysis preoperative C reactive protein (CRP) levels, advanced age and left atrium enlargement were associated with postoperative atrial fibrillation.
The results of this study suggest that although mild oxidative stress development and antioxidant respond occurs in coronary artery bypass surgery as a reason of ischemia reperfusion injury, an exaggerated oxidative stress development not balanced with antioxidant respond can be responsible at the pathogenesis of postoperative atrial fibrillation.
|Before Aortic Cross Clemp||After Aortic Cross Clemp||p value|
|TOS(μmol H2O2 Eq/)||19,69±18,92||34,37±18,99||0,002|
|TAC(mmol Trolox Eq/l)||2,24±0,33||2,42±0,44||0,044|
Oxidative stress indices and antioxidant respond during CABG in patients developed POAF