• Alexander Weymann, Aron-Frederik Popov, Anton Sabashnikov, Sadeq Ali-Hasan-Al-Saegh, Mikhail Ryazanov, Gary Tse, Seyed Jalil Mirhosseini, Tong Liu, Mohammadreza Lotfaliani, Meghdad Sedaghat, William L Baker, Azam Ghanei, Senol Yavuz, Mohamed Zeriouh, Payman Izadpanah, Hamidreza Dehghan, Luca Testa, Maryam Nikfard, SáMichel Pompeu Barros de OliveiraMPBO, Ahmed Mashhour, Luis Nombela-Franco, Mohammad Rezaeisadrabadi, Fabrizio D'Ascenzo, Konstantin Zhigalov, Umberto Benedetto, Soroosh Aminolsharieh Najafi, Marcin Szczechowicz, Leonardo Roever, Lei Meng, Mengqi Gong, Abhishek J Deshmukh, Tullio Palmerini, Cecilia Linde, Krzysztof J Filipiak, Gregg W Stone, Giuseppe Biondi-Zoccai, and Hugh Calkins.
• Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.. ghaneei_51@yahoo.com.
• Kardiol Pol. 2018 Jan 1; 76 (2): 440-451.

BackgroundPostoperative atrial fibrillation (POAF) is a leading arrhythmia with high incidence and serious clinical implications after cardiac surgery. Cardiac surgery is associated with systemic inflammatory response including increase in cytokines and activation of endothelial and leukocyte responses.AimThis systematic review and meta-analysis aimed to determine the strength of evidence for evaluating the association of inflammatory markers, such as C-reactive protein (CRP) and interleukins (IL), with POAF following isolated coronary artery bypass grafting (CABG), isolated valvular surgery, or a combination of these procedures.MethodsWe conducted a meta-analysis of studies evaluating measured baseline (from one week before surgical procedures) and postoperative levels (until one week after surgical procedures) of inflammatory markers in patients with POAF. A compre-hensive search was performed in electronic medical databases (Medline/PubMed, Web of Science, Embase, Science Direct, and Google Scholar) from their inception through May 2017 to identify relevant studies. A comprehensive subgroup analysis was performed to explore potential sources of heterogeneity.ResultsA literature search of all major databases retrieved 1014 studies. After screening, 42 studies were analysed including a total of 8398 patients. Pooled analysis showed baseline levels of CRP (standard mean difference [SMD] 0.457 mg/L, p < 0.001), baseline levels of IL-6 (SMD 0.398 pg/mL, p < 0.001), postoperative levels of CRP (SMD 0.576 mg/L, p < 0.001), postoperative levels of IL-6 (SMD 1.66 pg/mL, p < 0.001), postoperative levels of IL-8 (SMD 0.839 pg/mL, p < 0.001), and postoperative levels of IL-10 (SMD 0.590 pg/mL, p < 0.001) to be relevant inflammatory parameters significantly associated with POAF.ConclusionsPerioperative inflammation is proposed to be involved in the pathogenesis of POAF. Therefore, perioperative assessment of CRP, IL-6, IL-8, and IL-10 can help clinicians in terms of predicting and monitoring for POAF.

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