0491 : Preoperative plasma aldosterone levels can predict postoperative atrial fibrillation occurrence after coronary artery bypass surgery

Abstract

New-onset postoperative atrial fibrillation (POAF) is associated with poor short- and long-term outcomes after coronary artery bypass graft (CABG) and aortic valve replacement (AVR). Aldosterone has proarrhythmic and profibrotic effects on the heart. The relationship between plasma aldosterone levels and POAF after cardiac surgery has never been studied. The aim of this study was to examine this relationship in patients admitted for a programmed CABG (more or less AVR) in a prospective monocentric study. In 137 patients, we measured before cardiac surgery plasma aldosterone and both conventional echocardiography and left atrial (LA) strain assessed by speckle tracking imaging to assess LA function. POAF occurred in 34 of 137 patients (25%). Patients with POAF were significantly older than patients with normal sinus rhythm after surgery (73±8 vs 65±11 years, P < 0.05). Compared with patients with normal sinus rhythm, patients with POAF had significantly higher plasma aldosterone levels (221±116 vs 164±86, P<0.05). Plasma aldosterone levels were inversely correlated with LA global strain rate. By multivariate logistic regression analysis, both age and plasma aldosterone levels were independent predictors of POAF after CABG. Preoperative plasma aldosterone levels are associated with the development of POAF after CABG (more or less AVR). Further experiments are needed to clarify the underlying mechanisms involved. Moreover, these results could lead to the achievement of an interventional study regarding if aldosterone antagonist could decrease POAF occurrence in this context. The author hereby declares no conflict of interest