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Pre-operative serum VCAM-1 as a biomarker of atrial fibrillation after coronary artery bypass grafting

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Title: Pre-operative serum VCAM-1 as a biomarker of atrial fibrillation after coronary artery bypass grafting
Authors: Harling, L
Athanasiou, T
Ashrafian, H
Darzi, A
Gooderham, N
Lambert, J
Item Type: Journal Article
Abstract: Objective Systemic inflammation is a recognised contributory factor in the pathogenesis of de novo post-operative atrial fibrillation after cardiac surgery. This study aims to determine whether serum soluble vascular endothelial cell adhesion molecule (sVCAM-1) may predict the onset of POAF in patients under going coronary artery bypass grafting. Methods 34 patients undergoing non-emergent, on-pump CABG were prospectively recruited. Plasma was obtained at 24 h pre-operatively and at 48 and 96 h post-operatively. POAF was defined by continuous Holter recording. Inter-group comparisons were performed using student t-test or ANOVA as appropriate. Results Thirteen (13/34) patients developed POAF at a mean of 2.5 days post-operatively. Serum sVCAM-1 was significantly increased in the pre-operative serum of POAF when compared to non-POAF patients (p = 0.022). No significant difference was observed between the groups at 48 h (p = 0.073) or 96 h (p = 0.135) post-operatively. sVCAM-1 had a sensitivity of 60.0% and specificity of 77.27%, with an overall diagnostic accuracy of 75.2% in predicting POAF. Conclusions sVCAM-1 concentration in the pre-operative serum of patients undergoing CABG may accurately predict the onset of de novo POAF. As such, serum sVCAM-1 may be used as a predictive biomarker for this common arrhythmia. Further work must now perform prospective, targeted validation of these results in a larger patient cohort.
Issue Date: 18-Aug-2017
Date of Acceptance: 1-Aug-2017
URI: http://hdl.handle.net/10044/1/50325
DOI: https://dx.doi.org/10.1186/s13019-017-0632-2
ISSN: 1749-8090
Publisher: BioMed Central
Journal / Book Title: Journal of Cardiothoracic Surgery
Volume: 12
Copyright Statement: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Sponsor/Funder: Wellcome Trust
Funder's Grant Number: 100023/Z/12/Z
Keywords: Biomarker
Post operative atrial fibrillation
Vascular cell adhesion molecule
1103 Clinical Sciences
Respiratory System
Publication Status: Published
Article Number: 70
Appears in Collections:Department of Surgery and Cancer
Institute of Global Health Innovation