Atrial Fibrillation (AF), POAF
Conditions
Keywords
atrial fibrillation, Lp(a), Inflammation, Fibrosis
Brief summary
About one in three patients who undergo open-heart surgery develop an irregular heart rhythm called postoperative atrial fibrillation (POAF). This condition increases the risk of stroke, prolongs hospital stays, and raises the chances of complications and death compared with patients who do not develop it. Because of these serious outcomes, researchers are working to identify which patients are most at risk. One potential blood marker is lipoprotein(a), or Lp(a). Higher levels of Lp(a) have been linked to abnormal heart rhythms in previous studies. We want to determine whether patients with elevated Lp(a) are more likely to develop POAF after heart surgery and better understand the biological mechanisms behind this risk. In this study, patients will be grouped based on whether they have high or low Lp(a) levels. All participants will wear a chest band monitor that continuously tracks heart rhythm for 3 months after surgery to detect POAF. During surgery, small tissue samples from the heart will also be collected. By examining these samples, we will assess whether patients with elevated Lp(a) show more scarring and inflammation which are two pathways known to cause abnormal heart rhythms. The goal of this study is to determine whether elevated Lp(a) increases susceptibility to POAF. This could help identify patients who may benefit from preventive treatments and closer monitoring. By understanding how Lp(a) affects heart tissue, we also hope to uncover the mechanisms that contribute to abnormal rhythm and guide the development of future targeted therapies to treat POAF and other heart rhythms.
Interventions
None listed
Sponsors
Anthony Tang
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years * Scheduled for elective or urgent CABG, valve replacement, or combined CABG and valve replacement * Willing to wear the Skiin chest band for the duration of the study * Have a smartphone with an Operating System compatible with the * Skiin Connected Life App (Android 9+ or iOS 13+)
Exclusion criteria
* Emergency indication for CABG, valve replacement, or combined CABG and valve replacement * Prior cardiac surgery * History of pre-operative persistent atrial fibrillation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Lp(a) levels and POAF incidence | 3 months post-operation | Incidence of Postoperative Atrial Fibrillation (POAF), as Detected by Continuous ECG Monitoring, Stratified by Preoperative Lp(a) Level (≥125 nmol/L vs \<125 nmol/L) |
| Lp(a) Levels and POAF Burden | 3 months post-operation | Total Duration of POAF Episodes During the 3-Month Monitoring Period, Stratified by Preoperative Lp(a) Level (≥125 nmol/L vs \<125 nmol/L) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PAOF burden and atrial fibrosis and inflammation | Tissue will be collected during surgery | Histological and Transcriptional Markers of Atrial Fibrosis and Inflammation in Left Atrial Appendage Tissue, Correlated with POAF Incidence and Burden |
| Lp(a) levels and atrial fibrosis and inflammation | Tissue will be collected during surgery | Histological and Transcriptional Markers of Atrial Fibrosis and Inflammation in Left Atrial Appendage Tissue, Stratified by Preoperative Lp(a) Level (≥125 nmol/L vs \<125 nmol/L) |
| Lp(a) Levels and Serum Inflammatory Markers | Blood will be collected at baseline, day 1 postoperative and day 30 pos-operative | Serum Inflammatory Cytokine Levels, as Measured by ELISA, at Baseline, Postoperative Day 1, and Postoperative Day 90, Stratified by Preoperative Lp(a) Level (≥125 nmol/L vs \<125 nmol/L) |
Outcome results
None listed