The utility of mean platelet volume as a predictor of postoperative atrial fibrillation following coronary artery bypass grafting

Yıl 2020, , 438 - 442, 01.06.2020

Mustafa Çağdaş Çayır

https://doi.org/10.28982/josam.742726

Cited By: 1

Öz

Aim: Atrial fibrillation is the most common arrhythmia following coronary artery bypass grafting (CABG). The predictors of postoperative atrial fibrillation (POAF) following CABG are controversial. The aim of this study was to evaluate the predictivity of mean platelet volume (MPV) in the development of atrial fibrillation following CABG and other risk factors affecting POAF. 

Methods: A total of 227 patients who underwent on-pump CABG in the cardiovascular surgery department of our hospital between May 2016 and January 2019 were included in this retrospective cohort study. Patients were divided into two groups as those who underwent POAF and those who did not (non-POAF group). Patients’ demographic data such as age, gender, height, weight and BMI, biochemical parameters, comorbidities, smoking status, ejection fraction, the number of bypassed vessels, the use of intra-aortic balloon pump and inotropic agents, total drainage, neurological and other complications, operation time, duration of admission in intensive care unit and in the ward, and mortality status were recorded and comparatively analyzed. 

Results: No statistically significant differences were found between the groups in terms of gender, body mass index, the incidences of diabetes mellitus, hypertension, chronic obstructive pulmonary disease, pulmonary arterial hypertension, renal failure, smoking status, the number of bypassed vessels, the use of intra-aortic balloon pump, inotropic agents, and biochemical parameters (P<0.05 for all) except red cell distribution width (RDW), urea and mean platelet volume (MPV). MPV, RDW and urea values were significantly higher in the POAF group (P=0.004, P=0.018 and P=0.006, respectively). Multivariate regression analysis revealed that age, MPV and the amount of total drainage were independent risk factors for developing POAF (OR=1.080, OR=1.371, OR=1.001; P=0.001, P<0.001, P=0.024, respectively).

Conclusion: MPV can be used as a predictor for the development of POAF following on-pump CABG. MPV is a quite simple parameter, which can be readily obtained in routine complete blood count. However, our results should be supported by further prospective, multicenter and large-scale studies.

Anahtar Kelimeler

Postoperative atrial fibrillation, Mean platelet volume, Coronary artery bypass grafting, Biochemical parameters

Koroner arter baypas greftleme sonrası postoperatif atriyal fibrilasyonun bir prediktörü olarak ortalama trombosit hacminin kullanımı

Öz

Amaç: Atriyal fibrilasyon koroner arter baypas greftleme (KABG) sonrası en sık görülen aritmidir. CABG'yi takiben postoperatif atriyal fibrilasyonun (POAF) belirleyicileri tartışmalıdır. Bu çalışmanın amacı, CABG'yi takiben POAF gelişimi ve POAF'ı etkileyen diğer risk faktörleri için ortalama trombosit hacminin (MPV) kullanımını değerlendirmektir.

Yöntemler: Bu retrospektif kohort çalışmamıza Mayıs 2016-Ocak 2019 tarihleri arasında hastanemizin kardiyovasküler kliniğinde pompalı CABG uygulanan toplam 227 hasta dahil edildi. Hastalar, POAF ve POAF olmayan gruplar olarak iki gruba ayrıldı. Hastaların yaş, cinsiyet, boy, kilo ve BMI gibi demografik verileri, biyokimyasal parametreler, komorbiditeler, sigara içme durumu, ejeksiyon fraksiyonu, baypas edilen damar sayısı, aort içi balon pompası (IABP) ve inotropik ajanlar, toplam drenaj, nörolojik ve diğer komplikasyonlar, operasyon süresi, yoğun bakım ünitesinde ve koğuşta yatış süresi ve mortalite durumu kaydedildi ve karşılaştırmalı olarak analiz edildi.

Bulgular: Gruplar arasında cinsiyet, vücut kitle indeksi, diabetes mellitus insidansı, hipertansiyon, kronik obstrüktif akciğer hastalığı, pulmoner arteriyel hipertansiyon, böbrek yetmezliği, sigara içme durumu, baypas edilen damar sayısı, IABP, inotropik ajanlar ve biyokimyasal parametreler (kırmızı hücre dağılım genişliği (RDW), üre ve MPV hariç anlamlı bir fark bulunmadı. MPV, RDW ve üre değerleri POAF grubunda POAF olmayanlara göre istatistiksel olarak anlamlı derecede yüksekti (sırasıyla P=0,004, P=0,018 ve P=0,006). Çok değişkenli regresyon analizinde, yaş ve toplam drenaj miktarı POAF gelişiminin bağımsız risk faktörleri olarak bulundu (sırasıyla OR=1,080, OR=1,371, OR=1,001; P=0,001, P<0,001, P=0,024).

Sonuç: MPV, pompalı CABG'yi takiben POAF gelişimi için bir belirteç olarak kullanılabilir. MPV, rutin tam kan sayımında kolayca elde edilebilen oldukça basit bir parametredir. Ancak, sonuçlarımız prospektif, çok merkezli ve büyük ölçekli çalışmalarla desteklenmelidir.

Anahtar Kelimeler

Postoperatif atriyal fibrilasyon, Ortalama trombosit hacmi, Koroner arter baypas greftleme, Biyokimyasal parametreler

Kaynakça

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