Perioperative Biomarkers Predicting Postoperative Atrial Fibrillation Risk After Coronary Artery Bypass Grafting: A Narrative Review

J Cardiothorac Vasc Anesth. 2020 Jul;34(7):1933-1941. doi: 10.1053/j.jvca.2019.09.022. Epub 2019 Sep 18.

Abstract

Postoperative atrial fibrillation (POAF) after cardiac surgery remains a highly prevalent and costly condition that negatively impacts patient quality of life and survival. Numerous retrospective studies, meta-analysis, and review papers have been reported identifying POAF risk based on patients' risk factors and clinical biomarkers. In this narrative review, the authors report significant variations among selected pre- and perioperative biomarkers used to predict POAF incidence in patients without a history of atrial fibrillation (AF). POAF prediction based on B-type natriuretic peptide, N-terminal pro B-type natriuretic peptide, C-reactive protein, interleukin-6, creatinine, and plasminogen activator inhibitor-1 differs significantly among different studies, thereby limiting their clinical utility to predict POAF risk with high accuracy. Conversely, soluble vascular endothelial cells adhesion molecule-1, soluble CD40 ligand, Galectin-3, and aldosterone show promise for better POAF prediction. However, the current datasets for these selected biomarkers are not of sufficient size to validate the broad clinical application specifically for patients with no prior history of AF.

Keywords: atrial fibrillation; biomarkers; coronary artery bypass graft; postoperative atrial fibrillation.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / etiology
  • Biomarkers
  • Coronary Artery Bypass / adverse effects
  • Endothelial Cells
  • Humans
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Quality of Life
  • Retrospective Studies
  • Risk Factors

Substances

  • Biomarkers