Do high levels of n-3 polyunsaturated fatty acids in cell membranes increase the risk of postoperative atrial fibrillation?
OBJECTIVE
Postoperative atrial fibrillation (POAF) has been associated with an inflammatory response to the surgical procedure. n-3 long-chain polyunsaturated fatty acids (LC-PUFA) have been proposed for the prevention of POAF. We investigated the relationship between the plasma concentration of inflammatory mediators, levels of n-3 LC-PUFA in red blood cell (RBC) membrane lipids, and the risk of POAF after coronary artery bypass grafting (CABG).


METHODS
A total of 125 patients who underwent CABG were studied. Inflammatory mediators in plasma and the content of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in RBC membranes were assessed.


RESULTS
Sixty-two patients (49.6%) developed POAF. The POAF group had higher RBC levels of total n-3 LC-PUFA and DHA than did patients remaining in sinus rhythm (p < 0.05). Of the inflammatory mediators, only postoperative interleukin-6 levels differed, being higher in the POAF group (p < 0.05). Inflammatory mediators were not independent predictors of POAF by multivariable logistic regression analysis. Higher levels of DHA and total n-3 LC-PUFA in RBC membranes, measured immediately prior to CABG and on postoperative day 3, were linearly associated with an increased risk of POAF (p < 0.05).


CONCLUSIONS
Our findings suggest that inflammatory mediators are not associated with the occurrence of POAF. Interestingly, high n-3 LC-PUFA levels in RBC membranes appear to increase the risk of POAF.
School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Lara
L
Bjorgvinsdottir
David O
DO
Arnar
Olafur S
OS
Indridason
Ragnhildur
R
Heidarsdottir
Kristin
K
Skogstrand
Bjarni
B
Torfason
David M
DM
Hougaard
Runolfur
R
Palsson
Gudrun V
GV
Skuladottir
D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology*; D002315:Cardiopulmonary Bypass / Q000706:statistics & numerical data; D016207:Cytokines / Q000378:metabolism; D004281:Docosahexaenoic Acids / Q000378:metabolism; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000378:metabolism; D004910:Erythrocyte Membrane / Q000378:metabolism; D015525:Fatty Acids, Omega-3 / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011300:Preoperative Care; D011446:Prospective Studies; D012307:Risk Factors
D016207:Cytokines; D015525:Fatty Acids, Omega-3; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid