Preoperative n-3 polyunsatured fatty acids are associated with a decrease in the incidence of early atrial fibrillation following cardiac surgery.
BACKGROUND
Atrial fibrillation (AF) after cardiac surgery is associated with increased mortality, morbidity, and expenditure. Controversial data exist on possible preventive effects of n-3 polyunsatured fatty acids (PUFAs) against postoperative AF. We investigated whether preoperative PUFA therapy is effective in reducing AF after cardiac surgery during the surgical hospitalization and/or the cardiac rehabilitation period.


METHODS
Over a 4-year period, 530 patients (363 men, 68.5%) with a mean age of 66.4 +/- 10.9 years, undergoing cardiac surgery were monitored for ''early AF'' and ''late AF'' defined as AF documented in the surgical department or during the rehabilitation program, respectively.


RESULTS
The overall incidence of early AF in the whole study sample was 44.7%, whereas late AF occurred in 14.7% patients. Patients with AF had a longer length of hospital and rehabilitation stay (10.4 +/- 9.8 vs 9.5 +/- 9.2 days, P = .025 and 24.2 +/- 15.3 vs 21.1 +/- 8.3 days, P = .008, respectively). Early AF occurred in 31.0% of the patients with preoperative PUFAs compared with 47.3% of those without them (P = .006). Conversely, late AF was not influenced by preoperative PUFA regimen (11.9% vs 15.2%, P = .43). Preoperative PUFAs were independently associated with a 46% reduction in risk of early AF development (OR 0.54, 95% CI 0.31-0.92), after propensity score analysis.


CONCLUSIONS
Preoperative PUFA therapy is associated with a decreased incidence of early AF after cardiac surgery but not late AF. Patients undergoing cardiac surgery may benefit from a preventive PUFA approach.
Department of Surgical Sciences, Cardiac Surgery Unit, Varese University Hospital, University of Insubria, Varese, Italy. giovannimariscalco@yahoo.it
Giovanni
G
Mariscalco
Simona
S
Sarzi Braga
Maciej
M
Banach
Paolo
P
Borsani
Vito Domenico
VD
Bruno
Martha
M
Napoleone
Cristina
C
Vitale
Gabriele
G
Piffaretti
Roberto F E
RF
Pedretti
Andrea
A
Sala
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D055815:Young Adult
D015525:Fatty Acids, Omega-3