title: Postoperative atrial fibrillation and total dietary antioxidant capacity in patients undergoing cardiac surgery: The Polyphemus Observational Study.
abstract: OBJECTIVE
  Postoperative atrial fibrillation is a major cause of morbidity and mortality for stroke after cardiac surgery. Both systemic inflammation and oxidative stress play a role in the initiation of postoperative atrial fibrillation after cardiac surgery. The possible association between long-term intake of antioxidant-rich foods and postoperative atrial fibrillation incidence was examined in patients undergoing cardiac surgery.
  
  
  METHODS
  A total of 217 consecutive patients (74% were men; median age, 68.4 years) undergoing cardiac surgery, mainly coronary artery bypass grafting and valve replacement or repair, were recruited from January 2010 to September 2012. Total antioxidant capacity was measured in foods by the Trolox equivalent antioxidant capacity assay. The European Prospective Investigation into Cancer and Nutrition Food Frequency Questionnaire was used for dietary total antioxidant capacity assessment. The association among tertiles of dietary total antioxidant capacity and postoperative atrial fibrillation incidence was assessed using multivariable logistic analysis.
  
  
  RESULTS
  The overall incidence of total arrhythmias and postoperative atrial fibrillation was 42.4% and 38.2%, respectively. In multivariable analysis, after adjustment for age, gender, use of hypoglycemic drugs, physical activity, education, previous diagnosis of atrial fibrillation, and total energy intake, patients in the highest tertile of dietary total antioxidant capacity had a lower risk of postoperative atrial fibrillation than patients in the 2 lowest tertiles (odds ratio, 0.46; 95% confidence interval, 0.22-0.95; P = .048). A restricted cubic spline transformation confirmed the nonlinear relationship between total antioxidant capacity (in continuous scale) and postoperative atrial fibrillation (P = .023). When considering only coronary artery bypass grafting, valve replacement/repair, and combined surgeries, the protective effect on postoperative atrial fibrillation of a diet rich in antioxidants was confirmed.
  
  
  CONCLUSIONS
  Long-term consumption of antioxidant-rich foods is associated with a reduced incidence of postoperative atrial fibrillation in patients undergoing cardiac surgery.
authors.affiliation: Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy. Electronic address: simona.costanzo@neuromed.it.
authors.forename: Simona
authors.initials: S
authors.lastname: Costanzo
authors.affiliation: Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: Amalia
authors.initials: A
authors.lastname: De Curtis
authors.affiliation: Nuovo Ospedale Civile di Sassuolo, Sassuolo, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: di Niro
authors.affiliation: EPICOMED Research, srl, Campobasso, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Olivieri
authors.affiliation: Department of Cardiovascular Disease, Fondazione di Ricerca e Cura "Giovanni Paolo II," Campobasso, Italy.
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Morena
authors.affiliation: Department of Cardiovascular Disease, Fondazione di Ricerca e Cura "Giovanni Paolo II," Campobasso, Italy.
authors.forename: Carlo Maria
authors.initials: CM
authors.lastname: De Filippo
authors.affiliation: Department of Cardiovascular Disease, Fondazione di Ricerca e Cura "Giovanni Paolo II," Campobasso, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Caradonna
authors.affiliation: Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Krogh
authors.affiliation: Functional Food and Metabolic Stress Prevention Laboratory, Agricultural Research Center, CRA-NUT, Rome, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Serafini
authors.affiliation: Department of Food Science, University of Parma, Parma, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Pellegrini
authors.affiliation: Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: Maria Benedetta
authors.initials: MB
authors.lastname: Donati
authors.affiliation: Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Gaetano
authors.affiliation: Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (IS), Italy.
authors.forename: Licia
authors.initials: L
authors.lastname: Iacoviello
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D016017:Odds Ratio; D011446:Prospective Studies; D065840:Protective Factors; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants