The association of troponin I with the incidence of atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG): A prospective cohort.

Abstract

Objectives: Atrial fibrillation (AF) occurs in 15-45% of patients who underwent coronary artery bypass graft (CABG) surgery. Inflammation, myocardial ischemia, and sympathetic activity are the main contributing factors to postoperative atrial fibrillation (POAF) occurrence. POAF causes increased mortality, morbidity, and healthcare costs. Cardiac troponin I (c-TnI) is a sensitive and exclusive biomarker for myocardial injury. We investigated if c-TnI serum level had any correlation with POAF after CABG.

Method: We enrolled 100 stable patients undergoing elective on-pump CABG surgery. We measured c-TnI serum levels preoperative, postoperative, and 72-h post-CABG. All patients were evaluated with 12-lead ECG and continuous cardiac monitoring for 5 days to detect arrhythmias.

Result: Twelve (12%) patients developed AF after the operation. Although the AF group's age and BMI were slightly higher, there was no notable clinical, laboratory, or surgical difference between the groups. In addition, the preoperative, postoperative, and 72-h post-CABG c-TnI levels didn't show a significant difference between the groups. In contrast, the post-operation c-TnI rise was significantly higher in the AF group (p < 0.05). We determined a 1.9 ng/ml cutoff for post-operation c-TnI rise using the ROC curve with 100% sensitivity and 33% specificity.

Conclusion: We discover that post-operation c-TnI rise could be used as a predictive parameter for POAF with full sensitivity.