title: Systemic vascular cell adhesion molecule-1 predicts the occurrence of post-operative atrial fibrillation.
abstract: BACKGROUND
  Post-operative atrial fibrillation occurs in 30% of patients after on-pump heart surgery and is associated to elevated inflammatory markers. We have evaluated if the systemic biomarkers of inflammation and endothelial damage, vascular cell adhesion molecule-1 (VCAM-1) and soluble thrombomodulin may help in identifying patients prone to development of post-operative atrial fibrillation.
  
  
  METHODS
  One hundred and forty-four patients in sinus rhythm submitted to elective coronary artery bypass surgery. Systemic inflammatory, oxidative stress and endothelial damage markers were measured at baseline and 72 h after surgery. During the procedure, a sample of the right atrial appendage was obtained for histochemistry. Electrocardiogram was monitored for 72 h after surgery for event adjudication.
  
  
  RESULTS
  22% of the patients developed post-operative atrial fibrillation. Baseline systemic inflammatory markers did not differ between patients with or without post-operative atrial fibrillation. However, baseline plasma VCAM-1 and thrombomodulin levels were significantly higher in patients who developed post-operative atrial fibrillation. After adjustment for age, gender, comorbidities and concurrent medication, circulating VCAM-1 remained as an independent predictor for post-operative atrial fibrillation development. No association was observed between systemic plasma VCAM-1 and VCAM-1 tissue expression in the right atrial appendage.
  
  
  CONCLUSIONS
  In patients undergoing coronary artery bypass surgery, elevated VCAM-1 levels predict a higher risk for post-operative atrial fibrillation. Plasma VCAM-1 elevation is not related to its expression in the right atria, suggesting that systemic endothelial damage rather than local changes pre-exist in patients who develop the arrhythmia.
authors.affiliation: Facultad de Medicina, Pontificia Universidad Catolica de Chile, Chile.
authors.forename: Hugo
authors.initials: H
authors.lastname: Verdejo
authors.forename: Juan
authors.initials: J
authors.lastname: Roldan
authors.forename: Lorena
authors.initials: L
authors.lastname: Garcia
authors.forename: Andrea
authors.initials: A
authors.lastname: Del Campo
authors.forename: Elia
authors.initials: E
authors.lastname: Becerra
authors.forename: Mario
authors.initials: M
authors.lastname: Chiong
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Mellado
authors.forename: Amalia
authors.initials: A
authors.lastname: Garcia
authors.forename: Ricardo
authors.initials: R
authors.lastname: Zalaquett
authors.forename: Sandra
authors.initials: S
authors.lastname: Braun
authors.forename: Bernardita
authors.initials: B
authors.lastname: Garayar
authors.forename: Sergio
authors.initials: S
authors.lastname: Gonzalez
authors.forename: Sergio
authors.initials: S
authors.lastname: Lavandero
authors.forename: Ramon
authors.initials: R
authors.lastname: Corbalan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; D019010:Vascular Cell Adhesion Molecule-1