Research Article
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Association with Platelet Distribution Width and New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting

Year 2018, Volume: 45 Issue: 3, 309 - 316, 05.09.2018

Ferhat Özyurtlu Gökhan Albayrak

https://doi.org/10.5798/dicletip.457254
Cited By: 1

Abstract

Objective:
The platelet distribution width (PDW) is one of the parameters of platelet
activation. The PDW directly measures the variability in platelet size. However,
there has been a limited number of data reported thus far on PDW and
postoperative AF in patients undergoing CABG. We aimed to investigate the
relationship between the PDW and postoperative AF in patients undergoing CABG.



Methods:
124 consecutive patients with sinus rhythm who had undergone CABG between July
2011 and December 2013 were evaluated. AF was defined as any episode of AF
lasting longer than 30 seconds. Complete blood count samples were analyzed
according to the results obtained within 48 hours of the preoperative and
postoperative period. 



Results:
The preoperative PDW levels were significantly lower in patients who had
developed AF than in the control group (56.5±14.8 vs. 50.9±10.0, p=0.015).
There was no correlation between the postoperative PDW levels and AF. The
preoperative white blood cell (WBC) and the neutrophil/lymphocyte ratio (NLR)
were found to be similar between the two groups, while the postoperative WBC
(13.9±5.7 vs. 10.5±3.6, p=0.000) and NLR (14.4±9.4 vs. 9.0±8.4, p: 0. 001)
levels were higher in the group of patients who had AF. An NLR of 8.5 predicted
post-CABG AF with a sensitivity of 73% and a specificity of 63%, and a WBC of
10 predicted post-CABG AF with a sensitivity of 77% and a specificity of 48%. 



Conclusion:
These results support the hypothesis that preoperative PDW level predicts
new-onset AF after CABG, but suggest that other factors are also important.

Keywords

Atrial fibrillation coronary artery bypass surgery platelet distribution width white blood cell

References

  • 1. Mathew JP, Fontes ML, Tudor IC, et al: A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA 2004; 291: 1720-9.
  • 2. Ahlsson A, Bodin L, Fengsrud E, Englund A: Patients with postoperative atrial fibrillation have a doubled cardiovascular mortality. Scand Cardiovasc J 2009; 12: 1-7.
  • 3. Zangrillo A ， Landoni G， Sparicio D， et al. Predictors of atrial fibrillation after offpump coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth. 2004 Dec; 18: 704-8.
  • 4. Kollar A， Lick SD， Vasquez KN， Conti VR. Relationship of atrial fibrillation and stroke after coronary artery bypass graft surgery ： when is anticoagulation indicated? Ann Thorac Surg. 2006 Aug; 82: 515-23.
  • 5. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link Between thrombosis and inflammation? Curr Pharm Des 2011; 17: 47–58.
  • 6. Choudhury A, Chung I, Blann AD, Lip GY. Platelet surface CD62P and CD63, mean platelet volume, and soluble/platelet P-selectin as indexes of platelet function in atrial fibrillation: a comparison of “healthy control subjects” and “disease control subjects” in sinüs rhythm. J Am Coll Cardiol 2007; 49: 1957–64.
  • 7. De Luca G, Venegoni L, Iorio S, Secco GG, Cassetti E, Verdoia M, Schaffer A, Coppo L, Bellomo G, Marino P; Novara Atherosclerosis Study Group. Platelet distribution width and the extent of coronary artery disease: Results from a large prospective study. Platelets 2010; 21: 508-14.
  • 8. Herve P, Humbert M, Sitbon O, et al. Pathobiology of pulmonary hypertension: the role of platelets and thrombosis. Clin Chest Med 22: 451–8.
  • 9. M M Khandekar, A S Khurana, S D Deshmukh, et al. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol. 2006 February; 59: 146–9. doi: 10.1136/jcp.2004.025387
  • 10. Vagdatli E, Gounari E, Lazaridou E, et al. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010; 14: 28–32.
  • 11. Chung MK, Martin DO, Sprecher D, et al. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation 2001; 104: 2886–91.
  • 12. Köroğlu S, Tuncer C, Acar G, et al. Relation of inflammatory and oxidative markers to the occurrence and recurrence of persistent atrial fibrillation. Turk Kardiyol Dern Ars. 2012 Oct; 40 : 499-504. doi: 10.5543/tkda.2012.64160.
  • 13. Fontes ML, Amar D, Kulak A, et al. Increased preoperative white blood cell count predicts postoperative atrial fibrillation after coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2009 Aug; 23: 484-7. doi: 10.1053/j.jvca.2009.01.030.
  • 14. Gibson PH, Cuthbertson BH, Croal BL, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery bypass grafting. Am J Cardiol. 2010 Jan 15; 105: 186-91. doi: 10.1016/j.amjcard.2009.09.007.
  • 15. Boos CJ, Anderson RA, Lip GY. Is atrial fibrillation an inflammatory disorder? Eur Heart J 2006; 27: 136–49.
  • 16. Sohara H, Amitani S, Kurose M, Miyahara K. Atrial fibrillation activates platelets and coagulation in a timedependent manner: A study in patients with paroxysmal atrial fibrillation. J Am Coll Cardiol 1997; 29: 106–12.
  • 17. M M Khandekar, A S Khurana, S D Deshmukh, et al. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol. 2006 February; 59: 146–9. doi: 10.1136/jcp.2004.025387
  • 18. Ihara A, Matsumoto K, Kawamoto T, et al. Evaluation of platelet indexes in patients with aortic aneurysm. Pathophysiol Haemost Thromb 2005; 34: 269e73. 19. U Turk, I Tengiz, E Ozpelit, et al. The relationship between platelet indices and clinical features of coronary artery disease. Kardiologia Polska 2013; 71, 11: 1129–34; DOI: 10.5603/KP.2013.0293.
  • 20. D Calvo, B Delgado, S González, et al. Platelet distribution width is associated with 1-year all-cause mortality in the elderly population. Journal of Clinical Gerontology & Geriatrics 4 (2013) 12e16.
  • 21. Beyan C, Kaptan K, Ifran A. Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with optical platelet aggregation responses in healthy volunteers. J Thromb Thrombolysis 2006; 22: 161e4.
  • 22. Santimone I, Di Castelnuovo A, De Curtis A, et al. White blood cell count, sex and age are major determinants of heterogeneity of platelet indices in an adult general population: results from the MOLI-SANI project. Haematologica 2011; 96: 1180e8.
  • 23. Lo B, Fijnheer R, Nierich AP, et al. C-reactive protein is a risk indicator for atrial fibrillation after myocardial revascularization. Ann Thorac Surg 2005; 79: 1530–5.
  • 24. Fontes ML, Amar D, Kulak A, et al. Increased preoperative white blood cell count predicts postoperative atrial fibrillation after coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2009 Aug; 23: 484-7. doi: 10.1053/j.jvca.2009.01.030.
  • 25. A Anselmi, G Possati, M Gaudino. Postoperative Inflammatory Reaction and Atrial Fibrillation: Simple Correlation or Causation?. Ann Thorac Surg 2009; 88:

Year 2018, Volume: 45 Issue: 3, 309 - 316, 05.09.2018

Ferhat Özyurtlu Gökhan Albayrak

https://doi.org/10.5798/dicletip.457254
Cited By: 1

Abstract

References

  • 1. Mathew JP, Fontes ML, Tudor IC, et al: A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA 2004; 291: 1720-9.
  • 2. Ahlsson A, Bodin L, Fengsrud E, Englund A: Patients with postoperative atrial fibrillation have a doubled cardiovascular mortality. Scand Cardiovasc J 2009; 12: 1-7.
  • 3. Zangrillo A ， Landoni G， Sparicio D， et al. Predictors of atrial fibrillation after offpump coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth. 2004 Dec; 18: 704-8.
  • 4. Kollar A， Lick SD， Vasquez KN， Conti VR. Relationship of atrial fibrillation and stroke after coronary artery bypass graft surgery ： when is anticoagulation indicated? Ann Thorac Surg. 2006 Aug; 82: 515-23.
  • 5. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link Between thrombosis and inflammation? Curr Pharm Des 2011; 17: 47–58.
  • 6. Choudhury A, Chung I, Blann AD, Lip GY. Platelet surface CD62P and CD63, mean platelet volume, and soluble/platelet P-selectin as indexes of platelet function in atrial fibrillation: a comparison of “healthy control subjects” and “disease control subjects” in sinüs rhythm. J Am Coll Cardiol 2007; 49: 1957–64.
  • 7. De Luca G, Venegoni L, Iorio S, Secco GG, Cassetti E, Verdoia M, Schaffer A, Coppo L, Bellomo G, Marino P; Novara Atherosclerosis Study Group. Platelet distribution width and the extent of coronary artery disease: Results from a large prospective study. Platelets 2010; 21: 508-14.
  • 8. Herve P, Humbert M, Sitbon O, et al. Pathobiology of pulmonary hypertension: the role of platelets and thrombosis. Clin Chest Med 22: 451–8.
  • 9. M M Khandekar, A S Khurana, S D Deshmukh, et al. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol. 2006 February; 59: 146–9. doi: 10.1136/jcp.2004.025387
  • 10. Vagdatli E, Gounari E, Lazaridou E, et al. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010; 14: 28–32.
  • 11. Chung MK, Martin DO, Sprecher D, et al. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation 2001; 104: 2886–91.
  • 12. Köroğlu S, Tuncer C, Acar G, et al. Relation of inflammatory and oxidative markers to the occurrence and recurrence of persistent atrial fibrillation. Turk Kardiyol Dern Ars. 2012 Oct; 40 : 499-504. doi: 10.5543/tkda.2012.64160.
  • 13. Fontes ML, Amar D, Kulak A, et al. Increased preoperative white blood cell count predicts postoperative atrial fibrillation after coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2009 Aug; 23: 484-7. doi: 10.1053/j.jvca.2009.01.030.
  • 14. Gibson PH, Cuthbertson BH, Croal BL, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery bypass grafting. Am J Cardiol. 2010 Jan 15; 105: 186-91. doi: 10.1016/j.amjcard.2009.09.007.
  • 15. Boos CJ, Anderson RA, Lip GY. Is atrial fibrillation an inflammatory disorder? Eur Heart J 2006; 27: 136–49.
  • 16. Sohara H, Amitani S, Kurose M, Miyahara K. Atrial fibrillation activates platelets and coagulation in a timedependent manner: A study in patients with paroxysmal atrial fibrillation. J Am Coll Cardiol 1997; 29: 106–12.
  • 17. M M Khandekar, A S Khurana, S D Deshmukh, et al. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol. 2006 February; 59: 146–9. doi: 10.1136/jcp.2004.025387
  • 18. Ihara A, Matsumoto K, Kawamoto T, et al. Evaluation of platelet indexes in patients with aortic aneurysm. Pathophysiol Haemost Thromb 2005; 34: 269e73. 19. U Turk, I Tengiz, E Ozpelit, et al. The relationship between platelet indices and clinical features of coronary artery disease. Kardiologia Polska 2013; 71, 11: 1129–34; DOI: 10.5603/KP.2013.0293.
  • 20. D Calvo, B Delgado, S González, et al. Platelet distribution width is associated with 1-year all-cause mortality in the elderly population. Journal of Clinical Gerontology & Geriatrics 4 (2013) 12e16.
  • 21. Beyan C, Kaptan K, Ifran A. Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with optical platelet aggregation responses in healthy volunteers. J Thromb Thrombolysis 2006; 22: 161e4.
  • 22. Santimone I, Di Castelnuovo A, De Curtis A, et al. White blood cell count, sex and age are major determinants of heterogeneity of platelet indices in an adult general population: results from the MOLI-SANI project. Haematologica 2011; 96: 1180e8.
  • 23. Lo B, Fijnheer R, Nierich AP, et al. C-reactive protein is a risk indicator for atrial fibrillation after myocardial revascularization. Ann Thorac Surg 2005; 79: 1530–5.
  • 24. Fontes ML, Amar D, Kulak A, et al. Increased preoperative white blood cell count predicts postoperative atrial fibrillation after coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2009 Aug; 23: 484-7. doi: 10.1053/j.jvca.2009.01.030.
  • 25. A Anselmi, G Possati, M Gaudino. Postoperative Inflammatory Reaction and Atrial Fibrillation: Simple Correlation or Causation?. Ann Thorac Surg 2009; 88:
There are 24 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Ferhat Özyurtlu 0000-0001-6814-1254

Gökhan Albayrak This is me 0000-0002-9082-8631

Publication Date September 5, 2018
Submission Date September 4, 2018
Published in Issue Year 2018 Volume: 45 Issue: 3

Cite

APA Özyurtlu, F., & Albayrak, G. (2018). Association with Platelet Distribution Width and New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting. Dicle Tıp Dergisi, 45(3), 309-316. https://doi.org/10.5798/dicletip.457254
AMA Özyurtlu F, Albayrak G. Association with Platelet Distribution Width and New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting. diclemedj. September 2018;45(3):309-316. doi:10.5798/dicletip.457254
Chicago Özyurtlu, Ferhat, and Gökhan Albayrak. “Association With Platelet Distribution Width and New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting”. Dicle Tıp Dergisi 45, no. 3 (September 2018): 309-16. https://doi.org/10.5798/dicletip.457254.
EndNote Özyurtlu F, Albayrak G (September 1, 2018) Association with Platelet Distribution Width and New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting. Dicle Tıp Dergisi 45 3 309–316.
IEEE F. Özyurtlu and G. Albayrak, “Association with Platelet Distribution Width and New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting”, diclemedj, vol. 45, no. 3, pp. 309–316, 2018, doi: 10.5798/dicletip.457254.
ISNAD Özyurtlu, Ferhat - Albayrak, Gökhan. “Association With Platelet Distribution Width and New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting”. Dicle Tıp Dergisi 45/3 (September 2018), 309-316. https://doi.org/10.5798/dicletip.457254.
JAMA Özyurtlu F, Albayrak G. Association with Platelet Distribution Width and New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting. diclemedj. 2018;45:309–316.
MLA Özyurtlu, Ferhat and Gökhan Albayrak. “Association With Platelet Distribution Width and New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting”. Dicle Tıp Dergisi, vol. 45, no. 3, 2018, pp. 309-16, doi:10.5798/dicletip.457254.
Vancouver Özyurtlu F, Albayrak G. Association with Platelet Distribution Width and New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting. diclemedj. 2018;45(3):309-16.

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https://doi.org/10.1016/j.hlc.2019.11.021