Skip to main content
Top
Published in: Journal of Cardiothoracic Surgery 1/2017

Open Access 01-12-2017 | Research article

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

Authors: Leanne Harling, Jonathan Lambert, Hutan Ashrafian, Ara Darzi, Nigel J. Gooderham, Thanos Athanasiou

Published in: Journal of Cardiothoracic Surgery | Issue 1/2017

Login to get access

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.
Literature
1.
go back to reference Filardo G, Adams J. Postoperative atrial fibrillation and late mortality after valvular surgery. Ann Thorac Surg. 2010;89(6):2073. author reply -4CrossRefPubMed Filardo G, Adams J. Postoperative atrial fibrillation and late mortality after valvular surgery. Ann Thorac Surg. 2010;89(6):2073. author reply -4CrossRefPubMed
2.
go back to reference Attaran S, Shaw M, Bond L, Pullan MD, Fabri BM. Atrial fibrillation postcardiac surgery: a common but a morbid complication. Interact Cardiovasc Thorac Surg. 2011. Attaran S, Shaw M, Bond L, Pullan MD, Fabri BM. Atrial fibrillation postcardiac surgery: a common but a morbid complication. Interact Cardiovasc Thorac Surg. 2011.
3.
go back to reference Filardo G, Hamilton C, Hamman B, Hebeler RF, Adams J, Grayburn P. New-onset postoperative atrial fibrillation and long-term survival after aortic valve replacement surgery. Ann Thorac Surg. 2010;90(2):474–9.CrossRefPubMed Filardo G, Hamilton C, Hamman B, Hebeler RF, Adams J, Grayburn P. New-onset postoperative atrial fibrillation and long-term survival after aortic valve replacement surgery. Ann Thorac Surg. 2010;90(2):474–9.CrossRefPubMed
4.
go back to reference Mariscalco G, Klersy C, Zanobini M, Banach M, Ferrarese S, Borsani P, Cantore C, Biglioli P, Sala A. Atrial fibrillation after isolated coronary surgery affects late survival. Circulation. 2008;118(16):1612–8.CrossRefPubMed Mariscalco G, Klersy C, Zanobini M, Banach M, Ferrarese S, Borsani P, Cantore C, Biglioli P, Sala A. Atrial fibrillation after isolated coronary surgery affects late survival. Circulation. 2008;118(16):1612–8.CrossRefPubMed
5.
go back to reference Mathew JP, Fontes ML, Tudor IC, Ramsay J, Duke P, Mazer CD, Barash PG, Hsu PH, Mangano DT. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA. 2004;291(14):1720–9.CrossRefPubMed Mathew JP, Fontes ML, Tudor IC, Ramsay J, Duke P, Mazer CD, Barash PG, Hsu PH, Mangano DT. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA. 2004;291(14):1720–9.CrossRefPubMed
6.
go back to reference Pepinsky B, Hession C, Chen LL, Moy P, Burkly L, Jakubowski A, Chow EP, Benjamin C, Chi-Rosso G, Luhowskyj S, et al. Structure/function studies on vascular cell adhesion molecule-1. J Biol Chem. 1992;267(25):17820–6.PubMed Pepinsky B, Hession C, Chen LL, Moy P, Burkly L, Jakubowski A, Chow EP, Benjamin C, Chi-Rosso G, Luhowskyj S, et al. Structure/function studies on vascular cell adhesion molecule-1. J Biol Chem. 1992;267(25):17820–6.PubMed
7.
go back to reference Verdejo H, Roldan J, Garcia L, Del Campo A, Becerra E, Chiong M, Mellado R, Garcia A, Zalaquett R, Braun S, Garayar B, Gonzalez S, Lavandero S, Corbalan R. Systemic vascular cell adhesion molecule-1 predicts the occurrence of post-operative atrial fibrillation. Int J Cardiol. 2011;150(3):270–6.CrossRefPubMed Verdejo H, Roldan J, Garcia L, Del Campo A, Becerra E, Chiong M, Mellado R, Garcia A, Zalaquett R, Braun S, Garayar B, Gonzalez S, Lavandero S, Corbalan R. Systemic vascular cell adhesion molecule-1 predicts the occurrence of post-operative atrial fibrillation. Int J Cardiol. 2011;150(3):270–6.CrossRefPubMed
8.
go back to reference Andresen TK, Svennevig JL, Videm V. Soluble VCAM-1 is a very early marker of endothelial cell activation in cardiopulmonary bypass. Perfusion. 2002;17(1):15–21.CrossRefPubMed Andresen TK, Svennevig JL, Videm V. Soluble VCAM-1 is a very early marker of endothelial cell activation in cardiopulmonary bypass. Perfusion. 2002;17(1):15–21.CrossRefPubMed
9.
go back to reference Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, Crijns HJ, Damiano RJ, Jr., Davies DW, DiMarco J, Edgerton J, Ellenbogen K, Ezekowitz MD, Haines DE, Haissaguerre M, Hindricks G, Iesaka Y, Jackman W, Jalife J, Jais P, Kalman J, Keane D, Kim YH, Kirchhof P, Klein G, Kottkamp H, Kumagai K, Lindsay BD, Mansour M, Marchlinski FE, McCarthy PM, Mont JL, Morady F, Nademanee K, Nakagawa H, Natale A, Nattel S, Packer DL, Pappone C, Prystowsky E, Raviele A, Reddy V, Ruskin JN, Shemin RJ, Tsao HM, Wilber D: 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace, 14(4):528-606. Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, Crijns HJ, Damiano RJ, Jr., Davies DW, DiMarco J, Edgerton J, Ellenbogen K, Ezekowitz MD, Haines DE, Haissaguerre M, Hindricks G, Iesaka Y, Jackman W, Jalife J, Jais P, Kalman J, Keane D, Kim YH, Kirchhof P, Klein G, Kottkamp H, Kumagai K, Lindsay BD, Mansour M, Marchlinski FE, McCarthy PM, Mont JL, Morady F, Nademanee K, Nakagawa H, Natale A, Nattel S, Packer DL, Pappone C, Prystowsky E, Raviele A, Reddy V, Ruskin JN, Shemin RJ, Tsao HM, Wilber D: 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace, 14(4):528-606.
10.
go back to reference Scridon A, Dobreanu D, Chevalier P, Serban RC. Inflammation, a link between obesity and atrial fibrillation. Inflamm Res. 2015;64(6):383–93.CrossRefPubMed Scridon A, Dobreanu D, Chevalier P, Serban RC. Inflammation, a link between obesity and atrial fibrillation. Inflamm Res. 2015;64(6):383–93.CrossRefPubMed
11.
go back to reference Boos CJ, Anderson RA, Lip GY. Is atrial fibrillation an inflammatory disorder? Eur Heart J. 2006;27(2):136–49.CrossRefPubMed Boos CJ, Anderson RA, Lip GY. Is atrial fibrillation an inflammatory disorder? Eur Heart J. 2006;27(2):136–49.CrossRefPubMed
12.
go back to reference Doo YC, Han SJ, Park WJ, Kim SM, Choi SH, Cho GY, Hong KS, Han KR, Lee NH, Oh DJ, Ryu KH, Rhim CY, Lee KH, Lee Y. Associations between C-reactive protein and circulating cell adhesion molecules in patients with unstable angina undergoing coronary intervention and their clinical implication. Clin Cardiol. 2005;28(1):47–51.CrossRefPubMed Doo YC, Han SJ, Park WJ, Kim SM, Choi SH, Cho GY, Hong KS, Han KR, Lee NH, Oh DJ, Ryu KH, Rhim CY, Lee KH, Lee Y. Associations between C-reactive protein and circulating cell adhesion molecules in patients with unstable angina undergoing coronary intervention and their clinical implication. Clin Cardiol. 2005;28(1):47–51.CrossRefPubMed
13.
go back to reference Liangos O, Kolyada A, Tighiouart H, Perianayagam MC, Wald R, Jaber BL. Interleukin-8 and acute kidney injury following cardiopulmonary bypass: a prospective cohort study. Nephron Clin Pract. 2009;113(3):c148–54.CrossRefPubMedPubMedCentral Liangos O, Kolyada A, Tighiouart H, Perianayagam MC, Wald R, Jaber BL. Interleukin-8 and acute kidney injury following cardiopulmonary bypass: a prospective cohort study. Nephron Clin Pract. 2009;113(3):c148–54.CrossRefPubMedPubMedCentral
14.
go back to reference Hastings NE, Feaver RE, Lee MY, Wamhoff BR, Blackman BR. Human IL-8 regulates smooth muscle cell VCAM-1 expression in response to endothelial cells exposed to atheroprone flow. Arterioscler Thromb Vasc Biol. 2009;29(5):725–31.CrossRefPubMedPubMedCentral Hastings NE, Feaver RE, Lee MY, Wamhoff BR, Blackman BR. Human IL-8 regulates smooth muscle cell VCAM-1 expression in response to endothelial cells exposed to atheroprone flow. Arterioscler Thromb Vasc Biol. 2009;29(5):725–31.CrossRefPubMedPubMedCentral
15.
go back to reference Boulbou MS, Koukoulis GN, Makri ED, Petinaki EA, Gourgoulianis KI, Germenis AE. Circulating adhesion molecules levels in type 2 diabetes mellitus and hypertension. Int J Cardiol. 2005;98(1):39–44.CrossRefPubMed Boulbou MS, Koukoulis GN, Makri ED, Petinaki EA, Gourgoulianis KI, Germenis AE. Circulating adhesion molecules levels in type 2 diabetes mellitus and hypertension. Int J Cardiol. 2005;98(1):39–44.CrossRefPubMed
16.
go back to reference Clausen P, Jacobsen P, Rossing K, Jensen JS, Parving HH, Feldt-Rasmussen B. Plasma concentrations of VCAM-1 and ICAM-1 are elevated in patients with Type 1 diabetes mellitus with microalbuminuria and overt nephropathy. Diabet Med. 2000;17(9):644–9.CrossRefPubMed Clausen P, Jacobsen P, Rossing K, Jensen JS, Parving HH, Feldt-Rasmussen B. Plasma concentrations of VCAM-1 and ICAM-1 are elevated in patients with Type 1 diabetes mellitus with microalbuminuria and overt nephropathy. Diabet Med. 2000;17(9):644–9.CrossRefPubMed
Metadata
Title
Pre-operative serum VCAM-1 as a biomarker of atrial fibrillation after coronary artery bypass grafting
Authors
Leanne Harling
Jonathan Lambert
Hutan Ashrafian
Ara Darzi
Nigel J. Gooderham
Thanos Athanasiou
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2017
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-017-0632-2

Other articles of this Issue 1/2017

Journal of Cardiothoracic Surgery 1/2017 Go to the issue