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Cardiovascular Drugs and Therapy
Published in: Cardiovascular Drugs and Therapy 1/2024

Open Access 15-09-2022 | ß-Blockers | Original Article

Effect of Clinical and Genetic Factors on the Development of Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting (CABG) in Egyptian Patients Receiving Beta-Blockers

Authors: Dina M. K. El Gindy, Mohamed H. Solayman, Ramy Khorshid, Mona F. Schaalan, Lamia M. El Wakeel

Published in: Cardiovascular Drugs and Therapy | Issue 1/2024

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Abstract

Purpose

Prophylactic beta-blockers are recommended to prevent postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG). Polymorphisms in the beta-1 adrenergic receptor (ADRB1) and G protein-coupled receptor kinase 5 (GRK5) genes are associated with variable responses to beta-blockers. The aim of this study was to determine the clinical and genetic factors that influence the response to beta-blockers for POAF prophylaxis after CABG.

Methods

Patients undergoing isolated CABG and receiving prophylactic beta-blockers (n = 249) were prospectively recruited and followed up for 6 postoperative days. Genotyping of ADRB1 rs1801253, and 3 GRK5 SNPs (rs3740563, rs10787959, and rs17098707) was performed.

Results

Of the 249 patients, 52 patients (20.8%) experienced POAF. Age, hypertension, vasopressor use, calculated POAF risk score, GRK5 rs2230345 T-allele, and GRK5 rs3740563 A-allele were associated with POAF despite beta-blocker prophylaxis. The multivariate analysis revealed that age [odds ratio (OR) 1.06, 95% CI 1.02–1.11, p = 0.003] and GRK5 rs2230345 T-allele [OR 2.81, 95% CI 1.39–5.67, p = 0.004] were independent predictors of POAF after CABG despite beta-blocker prophylaxis.

Conclusion

GRK5 rs2230345 T-allele carriers were less responsive than AA genotype carriers to prophylactic beta-blockers for the prevention of POAF after CABG.
The study was registered on http://​clinicaltrials.​gov in March 2019, with trial registration number (TRN): NCT03871647.
Literature
1.
Gudbjartsson T, Helgadottir S, Sigurdsson MI, Taha A, Jeppsson A, Christensen TD, et al. New-onset postoperative atrial fibrillation after heart surgery. Acta Anaesthesiol Scand. 2020;64:145–55.CrossRefPubMed
2.
Greenberg JW, Lancaster TS, Schuessler RB, Melby SJ. Postoperative atrial fibrillation following cardiac surgery: a persistent complication. Eur J Cardio-thoracic Surg. 2017;52:665–72.CrossRef
3.
Mathew JP, Fontes ML, Tudor IC, Ramsay J, Duke P, Mazer CD, et al. A multicenter risk index for atrial fibrillation after cardiac surgery. J Am Med Assoc. American Medical Association. 2004;291:1720–9.CrossRef
4.
Kertai MD, Li YJ, Ji Y, Qi W, Lombard FW, Shah SH, et al. Genome-wide association study of new onset atrial fibrillation after coronary artery bypass grafting surgery. Am Heart J. 2015;170:580–59028 (Elsevier Inc.).CrossRefPubMedPubMedCentral
5.
Sigurdsson MI, Saddic L, Heydarpour M, Chang TW, Shekar P, Aranki S, et al. Post-operative atrial fibrillation examined using whole-genome RNA sequencing in human left atrial tissue. BMC Med Genomics BioMed Central Ltd. 2017;10:1–11.
6.
Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J Oxford Academic. 2021;42:373–498.CrossRef
7.
Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: executive summary. J Am Coll Cardiol. 2022;79:197–215.CrossRefPubMed
8.
Burrage PS, Low YH, Campbell NG, O’Brien B. 2019 New-onset atrial fibrillation in adult patients after cardiac surgery. Curr Anesthesiol Rep. Europe PMC Funders 9:174
9.
Rezaei Y, Peighambari MM, Naghshbandi S, Samiei N, Ghavidel AA, Dehghani MR, et al. 2020 Postoperative atrial fibrillation following cardiac surgery: from pathogenesis to potential therapies. Am. J. Cardiovasc. Drugs Springer p. 19–49.
10.
Kertai MD, Li YWYJ, Li YWYJ, Shah SH, Kraus WE, Fontes MJL, et al. 2014 G protein-coupled receptor kinase 5 gene polymorphisms are associated with postoperative atrial fibrillation after coronary artery bypass grafting in patients receiving β-blockers. Circ Cardiovasc Genet. NIH Public Access 7:625.
11.
Cresci S, Kelly RJ, Cappola TP, Diwan A, Dries D, Kardia SLRL, et al. 2009 Clinical and genetic modifiers of long-term survival in heart failure. J Am Coll Cardiol. NIH Public Access 54:432.
12.
Parvez B, Chopra N, Rowan S, Vaglio JC, Muhammad R, Roden DM, et al. A common β1-adrenergic receptor polymorphism predicts favorable response to rate-control therapy in atrial fibrillation. J Am Coll Cardiol. 2012;59:49–56.CrossRefPubMedPubMedCentral
13.
Kolek MJ, Muehlschlegel JD, Bush WS, Murray KT, Stein CM, Benjamin M, et al. Genetic and clinical risk prediction model for postoperative atrial fibrillation. Circ Arrhythmia Electrophysiol Circ Arrhythm Electrophysiol. 2015;8:25–31.CrossRefPubMed
14.
Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ, et al. Pathophysiology and prevention of atrial fibrillation. Circulation Circulation. 2001;103:769–77.CrossRefPubMed
15.
Gold JI, Martini JS, Hullmann J, Gao E, Chuprun JK, Lee L, et al. Nuclear translocation of cardiac g protein-coupled receptor kinase 5 downstream of select Gq-activating hypertrophic ligands is a calmodulin-dependent process. PLoS One Public Library of Science. 2013;8:e57324.CrossRef
16.
Wang WCH, Mihlbachler KA, Bleecker ER, Weiss ST, Liggett SB. 2008 A polymorphism of GRK5 alters agonist-promoted desensitization of β2-adrenergic receptors. Pharmacogenet Genomics. NIH Public Access 18:729.
17.
Liggett SB, Cresci S, Kelly RJ, Syed FM, Matkovich SJ, Hahn HS, et al. 2008 A GRK5 polymorphism that inhibits β-adrenergic receptor signaling is protective in heart failure. Nat Med. NIH Public Access 14:510.
18.
Lobmeyer MT, Wang L, Zineh I, Turner ST, Gums JG, Chapman AB, et al. Polymorphisms in genes coding for GRK2 and GRK5 and response differences in antihypertensive treated patients. Pharmacogenet Genomics. 2011;21:42–9.CrossRefPubMedPubMedCentral
19.
Ramalingam S, Radhakrishnan S, Kaliappan T, Gopalan R, Subrahmanian M, Sankaran R. 2021 The genetics of cardiac failure: Role of a G protein-coupled receptor polymorphism in therapeutic response in an Indian population. J Clin Transl Res. Whioce Publishing Pte. Ltd 7:501.
20.
Liu L, Zhang L, Liu M, Zhang Y, Han X, Zhang Z. GRK5 polymorphisms and postoperative atrial fibrillation following coronary artery bypass graft surgery. Sci Rep Nature Publishing Group. 2015;5:1–6.
21.
Jeff JM, Donahue BS, Brown-Gentry K, Roden DM, Crawford DC, Stein CM, et al. 2014 Genetic variation in the β1-adrenergic receptor is associated with the risk of atrial fibrillation after cardiac surgery. Am Heart J. NIH Public Access 167.
22.
Auton A, Abecasis GR, Altshuler DM, Durbin RM, Bentley DR, Chakravarti A, et al. 2015 A global reference for human genetic variation. Nature. Nature Publishing Group p. 68–74.
Metadata
Title
Effect of Clinical and Genetic Factors on the Development of Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting (CABG) in Egyptian Patients Receiving Beta-Blockers
Authors
Dina M. K. El Gindy
Mohamed H. Solayman
Ramy Khorshid
Mona F. Schaalan
Lamia M. El Wakeel
Publication date
15-09-2022
Publisher
Springer US
Published in
Cardiovascular Drugs and Therapy / Issue 1/2024
Print ISSN: 0920-3206
Electronic ISSN: 1573-7241
DOI
https://doi.org/10.1007/s10557-022-07380-6

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