Over 800,000 people undergo Coronary Artery Bypass Graft (CABG) surgery annually for management of their Coronary Artery Disease (CAD) worldwide. Postoperative Atrial Fibrillation (PoAF) is a complication with a 30%-40% incidence after CABG surgery. PoAF is believed to cause additional complications and also possibly increase the total duration of hospital stay in these patients. It is also believed that local and systemic inflammation play a role in the development of this complication and the -174 G/C IL-6 gene polymorphism modulates the inflammatory response. A study is underway to evaluate any plausible association between the -174 G/C IL-6 genotype and PoAF in CABG patients at the Presbyterian University Hospital, Pittsburgh, PA.
As part of an interim analysis of the study with a proposed enrollment of 380 subjects, the -174 G/C Interleukin 6 genotype variant was determined in 91 CABG patients. Heart rate and rhythm were monitored continuously until discharge. Twenty nine subjects (31.84%) developed PoAF. Multivariate logistic regression analysis included -174 G/C genotype, age, race, sex and other risk factors that are considered to be associated with PoAF. The analysis of the collected data revealed age as a significant predictor of PoAF. Subjects older than 65 years had 2.7 times higher odds of developing PoAF as compared to subjects who were 65 years old or younger. The -174 G/C gene variant or any other predictors were not significantly associated with PoAF in these 91 CABG patients. The length of postoperative hospital stay was not found to be significantly associated with the presence of PoAF. However, this could be attributed to aggressive management of PoAF by our clinical care team.
With 15.3 million prevalence (USA-yr 2004) and the leading cause of mortality, CAD and its management are of enormous public health importance. PoAF needs to be explored further due to its ill defined etiopathology and the increasingly older patient population that undergo CABG surgery for their CAD. Any further knowledge derived on PoAF would pave way for better anticipation and prevention of this complication.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-08012007-215600 |
| Date | 27 September 2007 |
| Creators | Raghu, Sujatha |
| Contributors | Sati Mazumdar PhD, John Wilson PhD, Lawrence Wei MD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-08012007-215600/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
Page generated in 0.0131 seconds