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Background: Atrial fibrillation (AF) is the most common complication after cardiac surgery. The pathogenesis of postoperative atrial fibrillation (POAF) is multifactorial and one of the known factors is inflammation. Platelet mass index (PMI) is an indicator of platelet activation and a better inflammatory marker than mean platelet volume (MPV). In this retrospective study, we investigated the relationship between POAF and PMI., Methods: The study included 848 consecutive patients (655 male and 193 female) who had elective isolated coronary artery by-pass grafting (CABG) or combined CABG and valvular surgery. Platelet count and MPV were measured from preoperative blood samples to calculate PMI. Post-operative atrial fibrillation was defined as irregular and fibrillatory P waves occurring 48-96 h after cardiac surgery and lasting at least 30 s. The PMI values in patients who developed POAF were compared with those in patients who did not develop POAF., Results: Patients who developed POAF had higher PMI values (2549.3 ± 1077.1) when compared with patients in sinus rhythm (2248.1 ± 683.4; p < 0.01). In multivariate regression analysis, age (OR: 1.05; 95% CI: 1.02-1.09; p = 0.01), left atrial diameter (OR: 1.05; 95% CI: 1.03-1.09; p = 0.02), hs-CRP (OR: 1.09; 95%CI: 1.05-1.13; p < 0.01), EuroSCORE II (OR: 1.27; 95% CI: 1.14-1.41; p < 0.01), and PMI (OR: 1.01; 95% CI: 1.001-1.02; p < 0.01) were independent predictors of POAF. In ROC analysis, PMI ≥ 2286 predicted POAF development with a sensitivity of 69% and a specificity of 58% (AUC: 0.66; p < 0.01) CONCLUSION: A significant relationship was found between preoperatively calculated PMI and POAF. We showed that PMI may be used to predict patients who are at high risk of developing POAF., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

New onset atrial fibrillation (NOAF) in the case of acute myocardial infarction appears to be associated with inflammation. However, its influence alongside other risk factors is currently unknown. In this study, the effect of inflammation in predicting NOAF independent of left atrial volume index (LAVi) was investigated with a new marker, the C-reactive protein/Albumin ratio (CAR). We included 945 ST-elevation myocardial infarction (STEMI) patients who underwent pPCI. Two groups were defined according to the presence of NOAF and the groups were compared for demographic, clinical and angiographic findings. Predictors of the NOAF were assessed by multivariable regression analysis. Fifty-five (5.8%) patients had NOAF after the procedures. CAR was substantially higher in patients with NOAF (5.9 [4.9] vs 0.46 [1] p<0.01). CAR was shown as an independent marker for NOAF (OR:1.19 95% CI: 1.11-1.27 p<0.01) development in multivariable regression analysis. In receiver operating curve characteristics, the sensitivity and the specificity of the value CAR>4.2 were 64% and 81% (AUC: 0.86) respectively. In subgroup analysis, OR of CAR in LAVi ≥26.7 ml/m² was 19.5 and 22.1 in LAVi<26.7 ml/m² (p for interaction=0.02). A novel inflammatory marker, CAR has the potential to predict the development of NOAF regardless of LAVi in patients with STEMI treated by PPCI. [ABSTRACT FROM AUTHOR]

Thrombosis and distal embolization play crucial role in the etiology of no-reflow. CHA2DS2-VASc score is used to estimate the risk of thromboembolism in patients with atrial fibrillation. We tested the hypothesis that CHA2DS2-VASc can predict no-reflow among patients who underwent primary percutaneous coronary intervention (PCI). A total number of 2375 consecutive patients with ST-segment elevation myocardial infarction were assessed for the study. Patients were divided into 2 groups as no-reflow (n = 111) and control (n = 1670) groups according to post-PCI no-reflow status. CHA2DS2-VASc scores were calculated for all patients. CHA2DS2-VASc scores were significantly higher in the no-reflow group compared to the control group. After a multivariate regression analysis, CHA2DS2-VASc score remained as an independent predictor (odds ratio: 1.58, 95% confidence interval: 1.33-1,88, P < .001) of no-reflow. Receiver–operating characteristics analysis revealed the cutoff value of CHA2DS2-VASc score ≥2 as a predictor of no-reflow with a sensitivity of 66% and a specificity of 59%. Moreover, in-hospital mortality was also associated with significantly higher CHA2DS2-VASc scores. In conclusion, CHA2DS2-VASc score is associated with higher risk of no-reflow and in-hospital mortality rates in patients who underwent primary PCI. [ABSTRACT FROM AUTHOR]