title: Low Circulating Levels of Growth Differentiation Factor-15 Before Coronary Artery Bypass Surgery May Predict Postoperative Atrial Fibrillation.
abstract: OBJECTIVE
  To assess the role of growth differentiation factor-15 (GDF-15) as a potential new predictor of postoperative atrial fibrillation (POAF) after off-pump (OFP) and on-pump (ONP) coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  Prospective, single-center, observational study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  The first 50 patients planned for OFP surgery and the first 50 patients planned for ONP surgery among patients referred for CABG with the following exclusion criteria: age<18 or>80 years, previous atrial fibrillation/flutter, previous treatment with amiodarone, previous cardiac surgery, and emergency surgery.
  
  
  METHODS
  Included patients were equipped with long-duration (7 days) Holter-ECG monitoring.
  
  
  RESULTS
  POAF was defined as an AF episode lasting>30 seconds. All patients underwent preoperative echocardiography to assess left ventricular ejection fraction and left atrial diameter. GDF-15 levels were assessed after induction of anesthesia and 12 hours after arrival at the intensive care unit. Among the 100 patients, 34 (34%) developed POAF. In Cox multivariate regression analysis, the EuroSCORE, left atrial diameter>45 mm, and low GDF-15 levels at induction were associated independently with the onset of POAF. In contrast, preoperative NT-proBNP levels did not predict POAF. The use of ONP surgery was not associated with a higher incidence of POAF, even though baseline and follow-up characteristics in ONP and OFP patients were identical.
  
  
  CONCLUSIONS
  In patients with no history of AF, a low plasma level of GDF-15 before CABG surgery was a strong independent predictor of POAF. Moreover, preoperative plasma GDF-15 levels added an incremental predictive value to classic risk factors of POAF.
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital, Dijon, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bouchot
authors.affiliation: Department of Cardiology, University Hospital, Dijon, France; INSERM, U866, LPPCM, Dijon, France. Electronic address: charles.guenancia@gmail.com.
authors.forename: Charles
authors.initials: C
authors.lastname: Guenancia
authors.affiliation: INSERM, U866, LPPCM, Dijon, France.
authors.forename: Abdelkader
authors.initials: A
authors.lastname: Kahli
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital, Dijon, France.
authors.forename: Charline
authors.initials: C
authors.lastname: Pujos
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital, Dijon, France.
authors.forename: Ghislain
authors.initials: G
authors.lastname: Malapert
authors.affiliation: INSERM, U866, LPPCM, Dijon, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Vergely
authors.affiliation: Department of Cardiology, University Hospital, Dijon, France; CNRS, UMR 5158, Le2I, Dijon, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Laurent
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000175:diagnosis*; D001026:Coronary Artery Bypass; D005260:Female; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15
keywords: atrial fibrillation; biochemistry; cardiopulmonary bypass; coronary artery bypass grafts; off-pump surgery