C-reactive protein levels and atrial fibrillation after cardiac surgery in women.
C-reactive protein levels and atrial fibrillation after cardiac surgery in women.
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女性心脏手术后 C 反应蛋白水平和心房颤动。
DOI：
10.1016/j.athoracsur.2006.02.043
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Damiano,Ralph
中科院分区：
文献类型：
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作者：
HogueJr,CharlesW;Palin,ChristopherA;Kailasam,Rajagopal;Lawton,JenniferS;Nassief,Abdullah;Davila-Roman,VictorG;Thomas,Betsy;Damiano,Ralph
研究背景本研究的目的是评估女性术后房颤的风险是否与通过血浆C-反应蛋白（CRP）浓度检测的预先存在的炎症有关。我们进一步寻求评估心房颤动的重要性，心脏手术后的妇女。METHODS的CRP测定前冠状动脉旁路移植术和（或）瓣膜手术使用心肺转流在141名妇女。单变量和多变量分析用于评估有和无房颤的女性之间CRP水平的差异，并评估心律失常和术后结局的重要性。46例（33%）女性发生了房颤。CRP浓度（中位数±标准误，13.3 ± 2.5 mg/L vs 11.7 ± 1.4 mg/L，p = 0.847）和水平升高的频率（定义为> 95%置信区间上限或>19.2 mg/L）（19% vs 21%，p = 0.807）在有或无房颤的女性之间均无差异。患者年龄和既往卒中史与房颤独立相关，而CRP水平与房颤无关。女性房颤患者更容易出现低心排综合征（p = 0.018），卒中（p = 0.031），重症监护室住院时间较长（p = 0.012）和术后（p = 0.0008）病房，他们更有可能在手术后需要延长护理设施（p = 0.046）.结论：与大多数男性研究结果相反，女性术前CRP浓度与心脏手术后房颤风险无关。女性患者术后房颤与卒中风险增加、住院时间延长和住院时间延长相关。
BACKGROUNDThe aim of this study was to evaluate whether risk for postoperative atrial fibrillation in women is related to preexisting inflammation as detected by plasma C-reactive protein (CRP) concentrations. We further sought to assess the importance of atrial fibrillation for outcome after cardiac surgery in women.METHODSThe CRP was measured before coronary artery bypass grafting and (or) valvular surgery using cardiopulmonary bypass in 141 women. Univariate and multivariate analyses were used to evaluate for differences in CRP levels between women with and without atrial fibrillation, and to assess for the importance of the arrhythmia and postoperative outcomes.RESULTSAtrial fibrillation developed in 46 (33%) women. Neither CRP concentrations (median ± standard error, 13.3 ± 2.5 mg/L vs 11.7 ± 1.4 mg/L, p = 0.847), nor the frequency of elevated levels (defined as > upper 95% confidence interval or >19.2 mg/L) (19% vs 21%, p = 0.807) differed between women with or without atrial fibrillation. Patient age and previous stroke, but not CRP levels, were independently associated with atrial fibrillation. Women with atrial fibrillation were more likely to have low cardiac output syndrome (p = 0.018), stroke (p = 0.031), longer duration of hospitalization in the intensive care unit (p = 0.012) and on the postoperative (p = 0.0008) ward, and they were more likely to require an extended care facility after surgery (p = 0.046).CONCLUSIONSIn contrast to findings from studies that have included mostly men, preoperative CRP concentrations are not associated with risk for atrial fibrillation after cardiac surgery for women. Postoperative atrial fibrillation in women is associated with increased risk for stroke, longer hospitalization, and extended care facility admission.