Preoperative n-3 Polyunsatured Fatty Acids Are Associated With a Decrease in the Incidence of Early Atrial Fibrillation Following Cardiac Surgery

• Published in: Angiology 2010-10, Vol.61 (7), p.643-650
• Main Authors: Mariscalco, Giovanni, Sarzi Braga, Simona, Banach, Maciej, Borsani, Paolo, Bruno, Vito Domenico, Napoleone, Martha, Vitale, Cristina, Piffaretti, Gabriele, Pedretti, Roberto F. E., Sala, Andrea
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Atrial Fibrillation - epidemiology; Atrial Fibrillation - prevention & control; Biological and medical sciences; Blood and lymphatic vessels; Cardiac Surgical Procedures - adverse effects; Cardiology. Vascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Fatty Acids, Omega-3 - therapeutic use; Female; Humans; Incidence; Length of Stay; Male; Medical sciences; Middle Aged; Multivariate Analysis; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Preoperative Care - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Young Adult
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/0003319710370962

Background: Atrial fibrillation (AF) after cardiac surgery is associated with increased mortality, morbidity, and expenditure. Controversial data exist on possible preventive effects of n-3 polyunsatured fatty acids (PUFAs) against postoperative AF. We investigated whether preoperative PUFA therapy is effective in reducing AF after cardiac surgery during the surgical hospitalization and/or the cardiac rehabilitation period. Methods: Over a 4-year period, 530 patients (363 men, 68.5%) with a mean age of 66.4 ± 10.9 years, undergoing cardiac surgery were monitored for ‘‘early AF’’ and ‘‘late AF’’ defined as AF documented in the surgical department or during the rehabilitation program, respectively. Results: The overall incidence of early AF in the whole study sample was 44.7%, whereas late AF occurred in 14.7% patients. Patients with AF had a longer length of hospital and rehabilitation stay (10.4 ± 9.8 vs 9.5 ± 9.2 days, P = .025 and 24.2 ± 15.3 vs 21.1 ± 8.3 days, P = .008, respectively). Early AF occurred in 31.0% of the patients with preoperative PUFAs compared with 47.3% of those without them (P = .006). Conversely, late AF was not influenced by preoperative PUFA regimen (11.9% vs 15.2%, P = .43). Preoperative PUFAs were independently associated with a 46% reduction in risk of early AF development (OR 0.54, 95% CI 0.31-0.92), after propensity score analysis. Conclusion: Preoperative PUFA therapy is associated with a decreased incidence of early AF after cardiac surgery but not late AF. Patients undergoing cardiac surgery may benefit from a preventive PUFA approach.