Table1_Patterns of cytokine release and association with new onset of post-cardiac surgery atrial fibrillation.docx

IntroductionPostoperative Atrial Fibrillation (POAF) is a common complication of cardiac surgery, associated with increased mortality, stroke risk, cardiac failure and prolonged hospital stay. Our study aimed to assess the patterns of release of systemic cytokines in patients with and without POAF.
MethodsA post-hoc analysis of the Remote Ischemic Preconditioning (RIPC) trial, including 121 patients (93 males and 28 females, mean age of 68 years old) who underwent isolated coronary artery bypass grafting (CABG) and aortic valve replacement (AVR). Mixed-effect models were used to analyze patterns of release of cytokines in POAF and non-AF patients. A logistic regression model was used to assess the effect of peak cytokine concentration (6 h after the aortic cross-clamp release) alongside other clinical predictors on the development of POAF.
ResultsWe found no significant difference in the patterns of release of IL-6 (p = 0.52), IL-10 (p = 0.39), IL-8 (p = 0.20) and TNF-α (p = 0.55) between POAF and non-AF patients. Also, we found no significant predictive value in peak concentrations of IL-6 (p = 0.2), IL-8 (p = >0.9), IL-10 (p = >0.9) and Tumour Necrosis Factor Alpha (TNF-α)(p = 0.6), however age and aortic cross-clamp time were significant predictors of POAF development across all models.
ConclusionsOur study suggests no significant association exists between cytokine release patterns and the development of POAF. Age and Aortic Cross-clamp time were found to be significant predictors of POAF.

引言
术后心房颤动（Postoperative Atrial Fibrillation, POAF）是心脏手术后的常见并发症，可导致死亡率升高、卒中风险增加、心力衰竭及住院时长延长。本研究旨在评估伴与不伴POAF患者的全身细胞因子释放模式。

研究方法
本研究为远程缺血预处理（Remote Ischemic Preconditioning, RIPC）临床试验的事后分析，纳入121例行单纯冠状动脉旁路移植术（CABG）联合主动脉瓣置换术（AVR）的患者，其中男性93例、女性28例，平均年龄68岁。采用混合效应模型分析伴POAF与非房颤患者的细胞因子释放模式；采用逻辑回归模型评估主动脉阻断松开后6小时的细胞因子峰值浓度，以及其他临床预测因素对POAF发生的影响。

研究结果
本研究发现，伴POAF与非房颤患者的白细胞介素6（IL-6，p=0.52）、白细胞介素10（IL-10，p=0.39）、白细胞介素8（IL-8，p=0.20）及肿瘤坏死因子α（TNF-α，p=0.55）释放模式无显著差异。同时，IL-6（p=0.2）、IL-8（p>0.9）、IL-10（p>0.9）及TNF-α（p=0.6）的峰值浓度均无显著预测价值，但年龄与主动脉阻断时长在所有模型中均为POAF发生的显著预测因素。

研究结论
本研究表明，细胞因子释放模式与POAF的发生无显著关联；年龄与主动脉阻断时长为POAF发生的显著预测因素。