Effect of preoperative vitamin D levels on the development of atrial fibrillation after cardiac bypass surgery
Effect of preoperative vitamin D levels on the development of atrial fibrillation after cardiac bypass surgery
Aim: Atrial fibrillation is a common complication after coronary bypass surgery. There are various studies aimed at predicting the development of postoperative atrial fibrillation (POAF). Low vitamin D status has been associated with an increased risk of cardiovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia. We purpose to evaluate the effect of serum25(OH) vitamin D level on the development of POAF after cardiac bypass surgery (CABG).Material and Methods: Our study is a retrospective chart review which all patients who underwent isolated, elective, on-pump CABG operation between January 2017 and January 2018. POAF was defined as the development of atrial fibrillation after the completion of cardiac surgery, which required intervention.The whole study population divided into two groups: group I, patients who developedPOAF and group II, patients who did not.Ejection fraction and left atrium diameter of participants were recorded. 25(OH)D and parathormone values, as well as other demographic and clinical characteristics, were collected.Results: A total of 78 patients were available for analyses. While 61 patients did not develop POAF, 17 patients developed. The rate of POAF was 22%. The median ages of the patients with and without POAF were significantly different (61(54-72) vs. 69(65- 77) years, p=0.012). The left atrial diameter was larger in patients with POAF (p=0.025). Preoperative ejection fractions were not different between the groups. Total bypass time and cross-clamp time were not significantly different. Although the mean value of preoperative 25(OH)D level was slightly higher in patients who did not develop POAF compared to that of patients with POAF, the difference was not statistically different between the groups.Conclusion: Preoperative 25(OH)D levels were not different between the patients with and without POAF.
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- 1. Bessissow A, Khan J, Devereaux PJ, et al. Postoperative atrial fibrillation in non-cardiac and cardiac surgery: an overview. J Thromb Haemost 2015;13:304-12.
- 2. Zakkar M, Ascione R, James AF, et al. Inflammation, oxidative stress, and postoperative atrial fibrillation in cardiac surgery. Pharmacol Ther 2015;154:13-20.
- 3. Ishii Y, Schuessler RB, Gaynor SL, et al. Inflammation of atrium after cardiac surgery is associated with inhomogeneity of atrial conduction and atrial fibrillation. Circulation 2005;111:2881-8.
- 4. Hanafy DA, Chang SL, Lu YY, et al. Electromechanical effects of 1,25-dihydroxy vitamin d with antiatrial fibrillation activities. J Cardiovasc Electrophysiol 2014;25:317-23.
- 5. Chen WR, Liu ZY, Shi Y, et al. Relation of low vitamin D to nonvalvular persistent atrial fibrillation in Chinese patients. Ann Noninvasive Electrocardiol 2014;19:166-73.
- 6. Demir M, Uyan U, Melek M. The effects of vitamin D deficiency on atrial fibrillation. Clin Appl Thromb Hemost 2014;20:98-103.
- 7. Alonso A, Misialek JR, Michos ED, et al. Serum 25-hydroxyvitamin D and the incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study. Europace 2016;18:1143-9.
- 8. Vitezova A, Cartolano NS, Heeringa J, et al. Vitamin D and the risk of atrial fibrillation--the Rotterdam Study. PLoS One 2015;10:0125161.
- 9. Mathew JS, Sachs MC, Katz R, et al. Fibroblast growth factor-23 and incident atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis (MESA) and the Cardiovascular Health Study (CHS). Circulation 2014;130:298-307.
- 10. Rienstra M, Cheng S, Larson MG, et al. Vitamin D status is not related to development of atrial fibrillation in the community. Am Heart J 2011;162:538-41.
- 11. Gode S, Aksu T, Demirel A, et al. Effect of vitamin D deficiency on the development of postoperative atrial fibrillation in coronary artery bypass patients. J Cardiovasc Thorac Res 2016;8:140-6.
- 12. Emren SV, Aldemir M, Ada F. Does Deficiency of Vitamin D Increase New Onset Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery? Heart Surg Forum 2016;19:180-4.
- 13. Skuladottir GV, Cohen A, Arnar DO, et al. Plasma 25-hydroxyvitamin D2 and D3 levels and incidence of postoperative atrial fibrillation. J Nutr Sci 2016;15:5- 10.
- 14. Cerit L, Kemal H, Gulsen K, et al. Relationship between Vitamin D and the development of atrial fibrillation after on-pump coronary artery bypass graft surgery. Cardiovasc J Afr 2017;28:104-7.
- 15. Daie M, Hajhossein Talasaz A, et al. Relationship between Vitamin D Levels and the Incidence of Post Coronary Artery Bypass Graft Surgery Atrial Fibrillation. J Tehran Heart Cent 2018;13:159-65.
- 16. Turin A, Bax JJ, Doukas D, et al. Interactions Among Vitamin D, Atrial Fibrillation, and the ReninAngiotensin-Aldosterone System. Am J Cardiol 2018;122:780-4.
- 17. Li YC. Vitamin D regulation of the renin-angiotensin system. J Cell Biochem 2003;88:327-31.
- 18. Zhang Z, Yang Y, Ng CY, et al. Meta-analysis of Vitamin D Deficiency and Risk of Atrial Fibrillation. Clin Cardiol 2016;39:537-43.
- 19. Ozcan OU, Gurlek A, Gursoy E, et al. Relation of vitamin D deficiency and new-onset atrial fibrillation among hypertensive patients. J Am Soc Hypertens 2015;9:307-12.
- 20. Belen E, Aykan AC, Kalaycioglu E, et al. Low-Level Vitamin D Is Associated with Atrial Fibrillation in Patients with Chronic Heart Failure. Adv Clin Exp Med 2016;25(1):51-7.
- 21. 21. Huang WL, Yang J, Yang J, et al. Vitamin D and new-onset atrial fibrillation: A meta-analysis of randomized controlled trials. Hellenic J Cardiol 2018;59:72-7.
- 22. Shen J, Lall S, Zheng V, et al. The persistent problem of new-onset postoperative atrial fibrillation: a singleinstitution experience over two decades. J Thorac Cardiovasc Surg 2011;141:559-70.
- 23. Greenberg JW, Lancaster TS, Schuessler RB, et al. Postoperative atrial fibrillation following cardiac surgery: a persistent complication. Eur J Cardiothorac Surg 2017;52:665-72.
- 24. Kara H, Yasim A. Effects of high-dose vitamin D supplementation on the occurrence of post-operative atrial fibrillation after coronary artery bypass grafting: randomized controlled trial. Gen Thorac Cardiovasc Surg 2019.
- 25. Cerit L, Ozcem B, Cerit Z, et al. Preventive Effect of Preoperative Vitamin D Supplementation on