Baseline and postoperative levels of C-reactive protein and interleukins as inflammatory predictors of atrial fibrillation following cardiac surgery: a systematic review and meta-analysis
Year: 2018
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: BACKGROUND: Postoperative atrial fibrillation (POAF) is a leading arrhythmia with high incidence and serious clinical implications after cardiac surgery. Cardiac surgery is associated with systemic inflammatory response including increase in cytokines and activation of endothelial and leukocyte responses. AIM: This systematic review and meta-analysis aimed to determine the strength of evidence for evaluating the association of inflammatory markers, such as C-reactive protein (CRP) and interleukins (IL), with POAF following isolated coronary artery bypass grafting (CABG), isolated valvular surgery, or a combination of these procedures. METHODS: We conducted a meta-analysis of studies evaluating measured baseline (from one week before surgical procedures) and postoperative levels (until one week after surgical procedures) of inflammatory markers in patients with POAF. A compre-hensive search was performed in electronic medical databases (Medline/PubMed, Web of Science, Embase, Science Direct, and Google Scholar) from their inception through May 2017 to identify relevant studies. A comprehensive subgroup analysis was performed to explore potential sources of heterogeneity. RESULTS: A literature search of all major databases retrieved 1014 studies. After screening, 42 studies were analysed including a total of 8398 patients. Pooled analysis showed baseline levels of CRP (standard mean difference [SMD] 0.457 mg/L, p < 0.001), baseline levels of IL-6 (SMD 0.398 pg/mL, p < 0.001), postoperative levels of CRP (SMD 0.576 mg/L, p < 0.001), postoperative levels of IL-6 (SMD 1.66 pg/mL, p < 0.001), postoperative levels of IL-8 (SMD 0.839 pg/mL, p < 0.001), and postoperative levels of IL-10 (SMD 0.590 pg/mL, p < 0.001) to be relevant inflammatory parameters significantly associated with POAF. CONCLUSIONS: Perioperative inflammation is proposed to be involved in the pathogenesis of POAF. Therefore, perioperative assessment of CRP, IL-6, IL-8, and IL-10 can help clinicians in terms of predicting and monitoring for POAF.
Source: Kardiologia Polska
Authors: Alexander Weymann, Aron-Frederik Popov, Anton Sabashnikov, Sadeq Ali-Hasan-Al-Saegh, Mikhail Ryazanov, Gary Tse, Seyed Jalil Mirhosseini, Tong Liu, Mohammadreza Lotfaliani, Meghdad Sedaghat, William L. Baker, Azam Ghanei, Senol Yavuz, Mohamed Zeriouh, Payman Izadpanah, Hamidreza Dehghan, Luca Testa, Maryam Nikfard, Michel Pompeu Barros de Oliveira Sá, Ahmed Mashhour, Luis Nombela-Franco, Mohammad Rezaeisadrabadi, Fabrizio D'Ascenzo, Konstantin Zhigalov, Umberto Benedetto, Soroosh Aminolsharieh Najafi, Marcin Szczechowicz, Leonardo Roever, Lei Meng, Mengqi Gong, Abhishek J. Deshmukh, Tullio Palmerini, Cecilia Linde, Krzysztof J. Filipiak, Gregg W. Stone, Giuseppe Biondi-Zoccai, Hugh Calkins
Institutions: Carl von Ossietzky Universität Oldenburg, Goethe University Frankfurt, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, University Hospital Frankfurt, University Hospital Cologne, Shahid Sadoughi University of Medical Sciences and Health Services, Chinese University of Hong Kong, Second Hospital of Tianjin Medical University, Tianjin Medical University, Shahid Beheshti University, Shahid Beheshti University of Medical Sciences, Hartford Hospital, University of Connecticut, S.B.Ü. Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Shiraz University, Shiraz University of Medical Sciences, IRCCS Policlinico San Donato, Universidade de Pernambuco, Hospital Clínico San Carlos, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Turin, University of Bristol, Universidade Federal de Uberlândia, Mayo Clinic, University of Bologna, Karolinska University Hospital, Karolinska Institutet, Medical University of Warsaw, NewYork–Presbyterian Hospital, Columbia University Irving Medical Center, Columbia University, Johns Hopkins University, Johns Hopkins Medicine, Istituto Neurologico Mediterraneo, Sapienza University of Rome
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W2774479879