Increased risk of atrial fibrillation among patients undergoing coronary artery bypass graft surgery while receiving nitrates and antiplatelet agents

Autor: Aaron L. Sverdlov, Linda C. Kindell, Stephen W. Davies, Jimmy T. Efird, Patricia B. Crane, Alan P. Kypson, Shahab A. Akhter, Ethan J. Anderson, Charulata Jindal, Andy C. Kiser
Rok vydání: 2018
Předmět:
Adult
Male
Inotrope
Medicine (General)
medicine.medical_specialty
Clinical Research Reports
inotropes
Coronary Artery Disease
030204 cardiovascular system & hematology
Biochemistry
03 medical and health sciences
chemistry.chemical_compound
R5-920
0302 clinical medicine
coronary artery bypass graft
nitric oxide
Risk Factors
postoperative atrial fibrillation
Atrial Fibrillation
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Coronary Artery Bypass
Cyclic guanosine monophosphate
Retrospective Studies
Nitrates
business.industry
Biochemistry (medical)
Antiplatelet agents
Cardiovascular Agents
Atrial fibrillation
Cell Biology
General Medicine
Perioperative
Middle Aged
nitrate tolerance
medicine.disease
3. Good health
Surgery
Increased risk
medicine.anatomical_structure
chemistry
Cohort
Female
business
Complication
Platelet Aggregation Inhibitors
Artery
Zdroj: The Journal of International Medical Research
Journal of International Medical Research, Vol 46 (2018)
ISSN: 1473-2300
0300-0605
DOI: 10.1177/0300060518773934
Popis: Background Postoperative atrial fibrillation (POAF) is a frequent complication of coronary artery bypass graft (CABG) surgery. This arrhythmia occurs more frequently among patients who receive perioperative inotropic therapy (PINOT). Administration of nitrates with antiplatelet agents reduces the conversion rate of cyclic guanosine monophosphate to guanosine monophosphate. This process is associated with increased concentrations of free radicals, catecholamines, and blood plasma volume. We hypothesized that patients undergoing CABG surgery who receive PINOT may be more susceptible to POAF when nitrates are administered with antiplatelet agents. Methods Clinical records were examined from a prospectively maintained cohort of 4,124 patients undergoing primary isolated CABG surgery to identify POAF-associated factors. Results POAF risk was increased among patients receiving PINOT, and the greatest effect was observed when nitrates were administered with antiplatelet therapy. Adjustment for comorbidities did not substantively change the study results. Conclusions Administration of nitrates with certain antiplatelet agents was associated with an increased POAF risk among patients undergoing CABG surgery. Additional studies are needed to determine whether preventive strategies such as administration of antioxidants will reduce this risk.
Databáze: OpenAIRE
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