Journal of Cardiothoracic and Vascular Anesthesia
Volume 23, Issue 1 , Pages 22-27 , February 2009

The Association Among Blood Transfusions, White Blood Cell Count, and the Frequency of Post–Cardiothoracic Surgery Atrial Fibrillation: A Nested Cohort Study From the Atrial Fibrillation Suppression Trials I, II, and III

  • Nitesh Sood, MD

      Affiliations

    • Division of Cardiology, Hartford Hospital, Hartford, CT
    • ,
  • Craig I. Coleman, PharmD

      Affiliations

    • Division of Drug Information, Hartford Hospital, Hartford, CT
    • University of Connecticut School of Pharmacy, Storrs, CT
    • ,
  • Jeffrey Kluger, MD, FACC

      Affiliations

    • Division of Cardiology, Hartford Hospital, Hartford, CT
    • University of Connecticut School of Medicine, Farmington, CT
    • ,
  • C. Michael White, PharmD, FCP, FCCP

      Affiliations

    • Division of Drug Information, Hartford Hospital, Hartford, CT
    • University of Connecticut School of Pharmacy, Storrs, CT
    • ,
  • Arun Padala, MD

      Affiliations

    • Division of Cardiology, Hartford Hospital, Hartford, CT
    • ,
  • William L. Baker, PharmD, BCPS

      Affiliations

    • Division of Drug Information, Hartford Hospital, Hartford, CT
    • Corresponding Author InformationAddress reprint requests to William L. Baker, PharmD, BCPS, Evidence-Based Practice Center, Hartford Hospital, 80 Seymour Street, CB309, Hartford, CT 06102

References 

  1. Baker WL, White CM. Postcardiothoracic surgery atrial fibrillation: a review of preventive strategies. Ann Pharmacother. 2007;41:587–598
  2. Mathew JP, Fontes ML, Tudor IC, et al. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA. 2004;291:1720–1729
  3. Gillespie EL, White CM, Kluger J, et al. A hospital perspective on the cost-effectiveness of beta-blockade for prophylaxis of atrial fibrillation after cardiothoracic surgery. Clin Ther. 2005;27:1963–1969
  4. Kim MH, Deeb GM, Morady F, et al. Effect of postoperative atrial fibrillation on length of stay after cardiac surgery (The Postoperative Atrial Fibrillation in Cardiac Surgery Study [PACS2]). Am J Cardiol. 2001;87:881–885
  5. Bruins P, te Velthuis H, Yazdanbakhsh AP, et al. Activation of the complement system during and after cardiopulmonary bypass surgery (Postsurgery activation involves c-reactive protein and is associated with postoperative arrhythmia). Circulation. 1997;96:3542–3548
  6. Gaudino M, Andreotti F, Zamparelli R, et al. The −174G/C interleukin-6 polymorphism influences postoperative interleukin-6 levels and postoperative atrial fibrillation (Is atrial fibrillation an inflammatory complication?). Circulation. 2003;108(suppl II):II-195–II-199
  7. Abdelhadi RH, Gurm HS, Van Wagoner DR, et al. Relation of an exaggerated risk in white blood cells after coronary bypass or cardiac valve surgery to development of atrial fibrillation postoperatively. Am J Cardiol. 2004;93:1176–1178
  8. Lamm G, Auer J, Weber T, et al. Postoperative white blood cell count predicts atrial fibrillation after cardiac surgery. J Cardiothorac Vasc Anesth. 2006;20:51–56
  9. Koch CG, Li L, Van Wagoner DR, et al. Red cell transfusion is associated with an increased risk for postoperative atrial fibrillation. Ann Thorac Surg. 2006;82:1747–1757
  10. Koch CG, Li L, Duncan AI, et al. Morbidity and mortality risk associated with red blood cell and blood-component transfusion in isolated coronary artery bypass grafting. Crit Care Med. 2006;34:1608–1616
  11. Murphy GJ, Reeves BC, Rogers CA, et al. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation. 2007;116:2544–2552
  12. Fransen E, Maessen J, Dentener M, et al. Impact of blood transfusions on inflammatory mediator release in patients undergoing cardiac surgery. Chest. 1999;116:1233–1239
  13. Giri S, White CM, Dunn AB, et al. Oral amiodarone for prevention of atrial fibrillation after open heart surgery, the Atrial Fibrillation Suppression Trial (AFIST): A randomized placebo-controlled trial. Lancet. 2001;357:830–836
  14. White CM, Caron MF, Kalus JS, et al. Intravenous plus oral amiodarone, atrial septal pacing, or both strategies to prevent post-cardiothoracic surgery atrial fibrillation: The Atrial Fibrillation Suppression Trial II (AFIST II). Circulation. 2003;108(suppl II):II-200–II-206
  15. White CM, Sander S, Coleman CI, et al. Impact of epicardial anterior fat pad retention on postcardiothoracic surgery atrial fibrillation incidence: The Atrial Fibrillation Suppression Trial III (AFIST III). J Am Coll Cardiol. 2007;49:298–303
  16. Graves EJ. National hospital discharge survey: Annual summary, 1991. Vital Health Stat. 1993;13:1–62
  17. Stover EP, Siegel LC, Parks R, et al. Variability in transfusion practice for coronary artery bypass surgery persists despite national consensus guidelines: A 24-institution study (Institutions of the Multicenter Study of Perioperative Ischemia Research Group). Anesthesiology. 1998;88:327–333
  18. Moise SF, Higgins MJ, Colquhoun AD. A survey of blood transfusion practice in UK cardiac surgery units. Crit Care. 2005;5(suppl a):4;abstr
  19. Bracey AW, Radovancevic R, Riggs SA, et al. Lowering the hemoglobin threshold for transfusion in coronary artery bypass procedures: Effect on patient outcome. Transfusion. 1999;39:1070–1077
  20. Ferraris VA, Gildengorin V. Predictors of excessive blood use after coronary artery bypass grafting: A multivariate analysis. J Thorac Cardiovasc Surg. 1989;98:492–497
  21. Cosgrove DM, Loop FD, Lytle BW, et al. Determinants of blood utilization during myocardial revascularization. Ann Thorac Surg. 1985;40:380–384
  22. Schreiber GB, Busch MP, Kleinman SH, et al. The risk of transfusion-transmitted viral infections: The Rotovirus Epidemiology Donor Study. N Engl J Med. 1996;334:1685–1690
  23. Leal-Noval SR, Rincon-Ferrari MD, Garcia-Curiel A, et al. Transfusion of blood components and postoperative infection in patients undergoing cardiac surgery. Chest. 2001;119:1461–1468
  24. Chelemer SB, Prato BS, Cox PM, et al. Association of bacterial infection and red blood cell transfusion after coronary artery bypass surgery. Ann Thorac Surg. 2002;73:138–142
  25. Engoren MC, Habib RH, Zacharias A, et al. Effect of blood transfusion on long-term survival after cardiac operation. Ann Thorac Surg. 2002;74:1180–1186
  26. Ishii Y, Schuessler RB, Gaynor SL, et al. Inflammation of atrium after cardiac surgery is associated with inhomogeneity of atrial conduction and atrial fibrillation. Circulation. 2005;111:2881–2888
  27. Kalus JS, Caron MF, White CM, et al. Impact of fluid balance on incidence of atrial fibrillation after cardiothoracic surgery. Am J Cardiol. 2004;94:1423–1425
  28. Ravelli F, Allessie M. Effects of atrial dilatation on refractory period and vulnerability to atrial fibrillation in the isolated Langendorff-perfused rabbit heart. Circulation. 1997;96:1686–1695
  29. Deroubaix E, Folliguet T, Rucker-Martin C, et al. Moderate and chronic hemodynamic overload of sheep atria induces reversible cellular electrophysiologic abnormalitites and atrial vulnerability. J Am Coll Cardiol. 2004;44:1918–1926
  30. Tang RB, Dong JZ, Liu XP, et al. Inflammation and atrial fibrillation: is Chlamydia pneumonia a candidate pathogen of atrial fibrillation?. Med Hypotheses. 2006;67:462–466

PII: S1053-0770(08)00187-0

doi: 10.1053/j.jvca.2008.06.009

Journal of Cardiothoracic and Vascular Anesthesia
Volume 23, Issue 1 , Pages 22-27 , February 2009

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