Arrhythmias & electrophysiologyCohort study
Impaired extracellular DNA clearance is associated with postoperative atrial fibrillation and mortality after cardiac surgery
- cohort
Authors' conclusion
Preoperative extracellular DNA burden and DNase activity associate with POAF and long-term mortality after major cardiovascular surgery. Impaired regulation of extracellular DNA reflects a vulnerability phenotype not captured by established clinical risk scores and provides incremental prognostic information.
Study context
- Population
- Patients undergoing major cardiovascular surgerypatients undergoing major cardiovascular surgery
- Participants
- 503 patients
Main finding
As reported in the abstract
Postoperative atrial fibrillation (POAF) occurred
42.1%
Observational data: associations, not effects.
Further findings
Double-stranded DNA (dsDNA) and POAF
- Baseline dsDNA levels did not differ between groups; multivariable analysis identified dsDNA as independently associated with POAF
- logistic regression adjusted for the CHA2DS2-VA score
Deoxyribonuclease (DNase) activity and POAF
- DNase activity independently associated with lower risk of POAF
DNase factor (dsDNA divided by DNase activity) and POAF
- DNase factor conferred an increased risk of POAF
Mortality · median follow-up of 72 months
- patients died
- 109 patients (21.7%)
- dsDNA independently predicted mortality
- Higher DNase activity independently associated with lower mortality
Incremental model fit
- Inclusion of the DNase factor significantly improved model fit beyond the CHA2DS2-VA score
Original publication
Summarised from the published abstract; every number is checked against it