Résumé
Atrial fibrillation [AF] is the most common type of arrhythmia following elective off-pump coronary bypass graft [CABG] surgery, occurring on the 2[nd] or 3[rd] postoperative day. Postoperative atrial fibrillation and early complications may be the cause of long term morbidity and mortality after hospital discharge. High sensitive C-reactive protein [hsCRP] seems to be most significantly associated with cardiovascular disorders. This study was designed to evaluate whether preoperative hsCRP [>/=3 mg/dl] can predict post-elective off-pump CABG, AF, and early complications in patients with severe left ventricle dysfunction [Ejection Fraction [EF] < 30%]. This study was conducted on 104 patients with severe left ventriclar dysfunction [EF < 30%], undergoing elective off-pump CABG surgery during April to September 2011 at the Afshar Cardiovascular Center in Yazd, Iran. Patients undergoing emergency surgery and those with unstable angina, creatinine higher than 2.0 mg/dl, malignancy, or immunosuppressive disease were excluded from the study. The subjects were divided into two groups: Group I with preoperative increased hsCRP [> 3 mg/dl] [n=51] and group N with preoperative normal hsCRP [< 3 mg/dl] [n=53]. We evaluated post-CABG variables including incidence, duration, and frequency of AF, early morbidity [bleeding, infection, vomiting, renal and respiratory dysfunctions], ICU or hospital stay and early mortality. Data were then analyzed by Analysis of Variance [ANOVA], Chi-square and Fisher exact test for quantitative and qualitative variables. The average age of the patients was 62.5 years, 75 cases [72.1%] were male, and 39 [37.5%] were female. Postoperative AF occurred in 19 cases [18.2%]; 17 cases [33.3%] had hsCRP >/= 3 mg/dl and 2 cases [3.8%] had hsCRP 0.05]. Preoperative hsCRP >/= 3 mg/dl can predict incidence of postoperative atrial fibrillation and early complications such as midsternotomy infection, respiratory dysfunction, and hospital stay following elective off-pump CABG