Relationship between apelin and new-onset atrial fibrillation after coronary artery bypass grafting: a prospective cohort study and retrospective case-control clinical trial

Abstract

Background: Coronary atherosclerotic heart disease as a chronic degenerative disease is the most common type of organ damage caused by atherosclerosis. Coronary artery bypass grafting is an internationally accepted treatment for coronary atherosclerotic heart disease. However, new-onset atrial fibrillation is a common complication after grafting, and its initiation and maintenance might be associated with levels of the peptide apelin. Methods/Design: A prospective cohort study and retrospective case-control clinical trial will be performed at the Department of Cardiac Surgery, General Hospital of Shenyang Military Region, China. We will recruit 120 patients without a history of atrial fibrillation and scheduled to undergo coronary artery bypass grafting. (1) Cohort study: patients will be assigned to two groups according to preoperative plasma apelin levels: high apelin (> 250 pg/mL) and low apelin (≤ 250 pg/mL). Seven days after surgery, the incidence of new-onset atrial fibrillation will be compared between the two groups. (2) Case-control study: those patients with new-onset atrial fibrillation will comprise the atrial fibrillation group, and those without will form the control group. MRI findings, and levels of plasma apelin, brain natriuretic peptide, and hypersensitive C-reactive protein, will be compared between the two groups 7 days postoperatively. Discussion: This trial is designed to investigate whether apelin can be used as an indicator to predict postoperative atrial fibrillation in patients with coronary atherosclerotic heart disease, and to provide an objective basis for the clinical selection of a preventive intervention program for atrial fibrillation. Trial registration: This trial was registered at ClinicalTrial.gov (NCT02807532). Ethics: The study protocol has acquired written approval from the Chinese Ethics Committee of Registering Clinical Trials (approval No. ChiECRCT-20150011), and will be performed in accordance with the Declaration of Helsinki formulated by the World Medical Association. Informed consent: Written informed consent will be obtained from each subject.