The Randomized Controlled Research On The Relationship Between Hs-CRP, IL-6 And Off Pump Coronary Artery Bypass Grafting Of New Onset Atrial Fibriuation

BACKGROUND:AF (Atrial fibrillation), one of the common complications after OPCAB (Off-Pump coronary artery bypass grafting) operation, seriously affect the recovery and quality of life of the patients after surgery, while greatly increasing the cost and operation risks. If the cardic rhythm of patients can not be controlled when AF happens, this will cause intra atrial thrombus sheddingand seriously change hemodynamic,finnally trigger cardiacvascular and cerebrovascular diseases. Recently with the improvement of people’s material life and the change of lifestyle, the incidence of coronary atherosclerosis heart disease rapidly raise and the OPCAB surgery has become the common treatment. Although there are comparatively perfect methods for treating atrial fibrillation in clinical, targeted research of prediction and preventive treatment for AF before OPCAB operation still processes poorly. This study aims to discuss how to perform early prediction for postoperative atrial fibrillation.Objective:Through comparing the preoperative and postoperative changes of inflammatory markers serum high sensitivity C-reactive protein (Hs-CRP) and interleukin-6 (IL-6) in the venous blood of patients and performing statistical analysis, we reveal the effect of the markers on the predictions for atrial fibrillation after the surgery and its clinical significance.Methods:70 patients without the history of clear AF, taking the antiarrhythmic drug, liver and kidney dysfunction or suffering from cancer, tissue damage, infection, acute myocardial infarction and other related inflammatory diseases (including 36 male patients and 34 female patients) were randomly selected from that accepted coronary artery bypass surgery in our hospital during the period from January 2013 to January 2015 and perquisit and record the information of patients. According to the data provided by ICU 24 hours Holter monitoring waveforms, we devided the patients into AF group and non-AF group, observed the preoperative and postoperative changes of Hs -CRP and IL-6 in blood at different time points and the established SPSS (Statistical Package for Social Sciences, Statistical Package for Social Sciences) data files to analyze the correlation between the changes of Hs -CRP/IL-6 andnew-onset atrial fibrillation after coronary artery bypass grafting operation.Results:70 patients with the average age 62.14±9.68 years old, among them there were 22 patients with the complications (31.4%) and 48 patients without complications after surgery. Compared with the non-AF group, the patients in AF group were elder (p<0.001) and have longer therapy time in surgical ICU (p<0.001), but other indications such as the history of hypertension and diabetes, BMI, the amount of bleeding during surgery and so on have no obvious difference.(P> 0.05) There were also no obvious difference in the levels of Hs-CRP and IL-6 of two group patients preoperatively(T-test, P>0.05), but the level of Hs-CRP and IL-6 significantly raised at 2/6/24/48/72 hours after surgery(T-test, P <0.05). Furthurmore, Hs-CRP began to increase at 2 hours after operation and reached the peak at 48 hours after operation, while IL-6 began to increase at 2 hours after operation and reached the peak at 6 hours after operation,Conclusions:1.The changes of Hs-CRP and IL-6 in the blood of patients may be one of the reasons for causing AF after OPC AB surgery.2.The changed levels of Hs-CRP and IL-6 in the blood of patients may have the effect on early predication of AF after OPCAB surgery.