TY - JOUR
T1 - Preoperative serum soluble receptor activator of nuclear factor-κB ligand and osteoprotegerin predict postoperative atrial fibrillation in patients undergoing cardiac valve surgery
AU - Cao, Hailong
AU - Zhou, Qing
AU - Wu, Yanhu
AU - Li, Qingguo
AU - Røe, Oluf Dimitri
AU - Chen, Yijiang
AU - Wu, Zhong
AU - Wang, Dongjin
N1 - Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
PY - 2013/9
Y1 - 2013/9
N2 - BACKGROUND: Postoperative atrial fibrillation (POAF), a frequent complication after cardiac surgery, causes morbidity and prolongs hospitalization. A significant association between circulating osteoprotegerin concentration and atrial fibrillation incidence had been identified. Osteoprotegerin/receptor activator of nuclear factor-κB/receptor activator of nuclear factor-κB ligand (RANKL) axis may also contribute to the development and progression of AF. Herein we sought to determine whether preoperative serum soluble RANKL and osteoprotegerin and soluble RANKL/osteoprotegerin ratio are associated with the incidence of POAF in cardiac surgery patients.METHODS: We enrolled 154 patients with preoperative sinus rhythm undergoing isolated cardiac valve surgery. Preoperative venous blood samples were obtained for measurement of serum soluble RANKL and osteoprotegerin. The POAF was defined as the characteristic arrhythmia lasting for at least 30 seconds before discharge. Comparison was made between patients without episode of POAF (sinus rhythm group, n=93) and patients experiencing POAF (atrial fibrillation group, n=61).RESULTS: Serum levels of soluble RANKL and osteoprotegerin and soluble RANKL/osteoprotegerin ratio were significantly higher in the atrial fibrillation group than the sinus rhythm group. In multivariate survival regression, C-reactive protein, ejection fraction, left and right atrial diameters, preoperative use of beta-blocker, duration of ventilation, particularly serum soluble RANKL level, and soluble RANKL/osteoprotegerin ratio independently predicted POAF. According to receiver operating characteristic curve analysis, the best threshold values of serum soluble RANKL level and soluble RANKL/osteoprotegerin ratio for predicting POAF were 3.62 pmol/L and 0.51, respectively.CONCLUSIONS: Elevated preoperative serum soluble RANKL level and soluble RANKL/osteoprotegerin ratio are independent predictors for POAF in patients undergoing cardiac valve surgery. These findings have important implications for identifying patients at higher risk of POAF who could be considered for prophylactic therapy.
AB - BACKGROUND: Postoperative atrial fibrillation (POAF), a frequent complication after cardiac surgery, causes morbidity and prolongs hospitalization. A significant association between circulating osteoprotegerin concentration and atrial fibrillation incidence had been identified. Osteoprotegerin/receptor activator of nuclear factor-κB/receptor activator of nuclear factor-κB ligand (RANKL) axis may also contribute to the development and progression of AF. Herein we sought to determine whether preoperative serum soluble RANKL and osteoprotegerin and soluble RANKL/osteoprotegerin ratio are associated with the incidence of POAF in cardiac surgery patients.METHODS: We enrolled 154 patients with preoperative sinus rhythm undergoing isolated cardiac valve surgery. Preoperative venous blood samples were obtained for measurement of serum soluble RANKL and osteoprotegerin. The POAF was defined as the characteristic arrhythmia lasting for at least 30 seconds before discharge. Comparison was made between patients without episode of POAF (sinus rhythm group, n=93) and patients experiencing POAF (atrial fibrillation group, n=61).RESULTS: Serum levels of soluble RANKL and osteoprotegerin and soluble RANKL/osteoprotegerin ratio were significantly higher in the atrial fibrillation group than the sinus rhythm group. In multivariate survival regression, C-reactive protein, ejection fraction, left and right atrial diameters, preoperative use of beta-blocker, duration of ventilation, particularly serum soluble RANKL level, and soluble RANKL/osteoprotegerin ratio independently predicted POAF. According to receiver operating characteristic curve analysis, the best threshold values of serum soluble RANKL level and soluble RANKL/osteoprotegerin ratio for predicting POAF were 3.62 pmol/L and 0.51, respectively.CONCLUSIONS: Elevated preoperative serum soluble RANKL level and soluble RANKL/osteoprotegerin ratio are independent predictors for POAF in patients undergoing cardiac valve surgery. These findings have important implications for identifying patients at higher risk of POAF who could be considered for prophylactic therapy.
KW - Adult
KW - Analysis of Variance
KW - Atrial Fibrillation
KW - Biological Markers
KW - Cohort Studies
KW - Female
KW - Heart Valve Diseases
KW - Heart Valve Prosthesis Implantation
KW - Humans
KW - Male
KW - Middle Aged
KW - Osteoprotegerin
KW - Postoperative Complications
KW - Predictive Value of Tests
KW - Preoperative Care
KW - Proportional Hazards Models
KW - Receptor Activator of Nuclear Factor-kappa B
KW - Regression Analysis
KW - Retrospective Studies
KW - Risk Assessment
KW - Solubility
KW - Statistics, Nonparametric
KW - Survival Rate
KW - Treatment Outcome
U2 - 10.1016/j.athoracsur.2013.04.042
DO - 10.1016/j.athoracsur.2013.04.042
M3 - Journal article
C2 - 23870696
SN - 0003-4975
VL - 96
SP - 800
EP - 806
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 3
ER -