The C-reactive protein/albumin ratio as a new predictor for postoperative atrial fibrillation after coronary artery bypass graft surgery

Background: This study aimed to investigate the predictive significance of C-reactive protein/albumin ratio for postoperative atrial fibrillation occurrence in patients who were underwent coronary artery bypass graft surgery.

Methods: Among 830 patients who underwent coronary artery bypass grafting with cardiopulmonary bypass between January 2016 and February 2020, 137 patients with no prior arrhythmia history were included in this cross sectional study.

Results: One hundred and thirty-seven (16.5%) patients developed atrial fibrillation in postoperative period. Patients who experienced postoperative atrial fibrillation were more likely to be older but displayed similar rates of diabetes mellitus, hypertension, hypercholesterolemia, cerebrovascular disease, peripheral vascular disease and chronic obstructive pulmonary disease. For prediction of postoperative atrial fibrillation development, diagnostic odds ratio (OR) and positive likelihood ratio of C-reactive protein/albumin ratio value (OR: 1.854; confidence interval [CI]: 1.598-2.142; P < .001) was higher than serum C-reactive protein and albumin levels. (OR: 1.159; CI: 1.115-1.201; P < .001; OR: 0.438; CI: 0.258-0.865; P < .001, respectively). Which means that C-reactive protein/albumin ratio may detect postoperative atrial fibrillation development better C-reactive protein itself.

Conclusion: Based on our results, patients who developed postoperative atrial fibrillation after coronary artery bypass grafting had significantly higher preoperative C-reactive protein/albumin ratio levels than patients who remained in normal sinus rhythm in the postoperative period. Also, higher C-reactive protein/albumin ratio value was one of the independent predictive factors for postoperative atrial fibrillation. Therefore, we concluded that evaluating preoperative C-reactive protein/albumin ratio value might provide early identification of patients with high risk for postoperative atrial fibrillation.

Keywords: C-reactive protein; albumin; atrial fibrillation; coronary artery bypass grafting.