Association between preoperative C-reactive protein and atrial fibrillation after off-pump coronary artery bypass grafting

Kaushik Roy; M. Kamrul Hasan; Sanjoy Kumar Raha; Al Masum Ziaul Hoque; Arvi Nahar; Sumit Barua; Nayeem Parvez; Nandita Sur Chowdhury

doi:10.18203/2349-2902.isj20261161

Authors

Kaushik Roy Department of Cardiac Surgery, United Medical College Hospital, Dhaka, Bangladesh
M. Kamrul Hasan Department of Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Sanjoy Kumar Raha Department of Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Al Masum Ziaul Hoque Department of Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Arvi Nahar Department of Pediatric Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Sumit Barua Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Nayeem Parvez Department of Cardiac Surgery, Impulse Hospital, Dhaka, Bangladesh
Nandita Sur Chowdhury Department of Anesthesia, BRB Hospitals Limited, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-2902.isj20261161

Keywords:

Atrial fibrillation, CAD, C-reactive protein, OPCAB

Abstract

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. This study aims to assess the association between preoperative C-reactive protein (CRP) levels and postoperative AF in Bangladeshi patients undergoing off-pump CABG.

Methods: This comparative, cross-sectional study was conducted at the Department of Cardiac Surgery, National Institute of Cardiovascular Diseases and Hospital (NICVD), Dhaka, Bangladesh, from July 2020 to June 2022, including 70 adult OPCAB patients divided by preoperative CRP levels (Group A: 0–<6 mg/l, Group B: 6–10 mg/l) to assess its association with postoperative atrial fibrillation. Standard preoperative evaluation, anesthesia, grafting and monitoring of intra- and postoperative events were performed, with data analyzed using SPSS-26 (p≤0.05).

Results: Among 70 patients undergoing off-pump CABG, baseline demographic, clinical, laboratory and operative variables were comparable between groups (all p>0.05). Group A had significantly shorter ICU stay (3.71±0.96 vs 3.75±0.91 days, p=0.010) and hospital stay (8.94±2.96 vs 10.91±2.81 days, p=0.006). Postoperative atrial fibrillation occurred more frequently in Group B (40.0%) than Group A (11.4%) (p=0.006). Multivariable analysis identified preoperative CRP (6–10 mg/dl) as the sole independent predictor of postoperative AF (OR 6.32, p=0.006).

Conclusions: Elevated preoperative CRP is an independent predictor of postoperative atrial fibrillation and prolonged ICU and hospital stay after off-pump CABG, highlighting its role in risk stratification and prevention.

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