Low preoperative selenium is associated with post-operative atrial fibrillation in patients having intermediate-risk coronary artery surgery

McDonald, C., Fraser, J., Shekar, K., Clarke, A., Coombes, J., Barnett, A., Pearse, B. and Fung, L. (2016) Low preoperative selenium is associated with post-operative atrial fibrillation in patients having intermediate-risk coronary artery surgery. European Journal of Clinical Nutrition, 70 10: 1138-1143. doi:10.1038/ejcn.2016.125


Author McDonald, C.
Fraser, J.
Shekar, K.
Clarke, A.
Coombes, J.
Barnett, A.
Pearse, B.
Fung, L.
Title Low preoperative selenium is associated with post-operative atrial fibrillation in patients having intermediate-risk coronary artery surgery
Journal name European Journal of Clinical Nutrition   Check publisher's open access policy
ISSN 1476-5640
0954-3007
Publication date 2016-10-01
Sub-type Article (original research)
DOI 10.1038/ejcn.2016.125
Open Access Status Not yet assessed
Volume 70
Issue 10
Start page 1138
End page 1143
Total pages 6
Place of publication London, United Kingdom
Publisher Nature Publishing Group
Language eng
Subject 2701 Medicine (miscellaneous)
2916 Nutrition and Dietetics
Abstract Background/objectives:Post-operative atrial fibrillation (POAF) is a frequent complication of cardiac surgery. Oxidative stress and reduced antioxidant function have major roles in its development. Selenium is a key to normal antioxidant function, and levels are often low before cardiac surgery. This study investigated whether low preoperative selenium levels were associated with POAF in cardiac surgical patients.Subjects/methods:Using the Society of Thoracic Surgeons (STS) Mortality risk score, 50 patients having primary coronary artery bypass grafts (CABG) surgery were divided into two groups: (i) low-risk group (STS ≤0.5%; n=26) and (ii) intermediate-risk group (STS ≥2.0%; n=24). Plasma levels of selenium, glutathione peroxidase (GPx) and malondialdehyde (MDA) were measured in all patients at anaesthetic induction, after aortic cross-clamp removal, 3 h post cardiopulmonary bypass and on post-operative days 1 and 5. Multiple logistic regression was used to assess whether selenium levels were associated with POAF development.Results:Seventeen patients developed POAF (14 patients in the intermediate-risk group and 3 patients in the low-risk group). Preoperative selenium was lower in patients who developed POAF compared with those with normal sinus rhythm (0.73±0.16 vs 0.89±0.13 μmol/l, P=0.005), and this was independently associated with POAF (PR 0.32; 95% confidence credible interval (95%cI) 0.06-0.85, P=0.016). Regardless of POAF, preoperative selenium was lower in the intermediate-risk patients than in the low-risk patients (0.77±0.15 vs 0.89±0.14 μmol/l; P=0.004).Conclusions:Intermediate-risk patients with low preoperative selenium levels may be at a greater risk of developing POAF following CABG. This raises the question of whether selenium supplementation in select cardiac surgical patients may reduce their POAF risk.
Formatted abstract
Background/objectives: Post-operative atrial fibrillation (POAF) is a frequent complication of cardiac surgery. Oxidative stress and reduced antioxidant function have major roles in its development. Selenium is a key to normal antioxidant function, and levels are often low before cardiac surgery. This study investigated whether low preoperative selenium levels were associated with POAF in cardiac surgical patients.

Subjects/methods: Using the Society of Thoracic Surgeons (STS) Mortality risk score, 50 patients having primary coronary artery bypass grafts (CABG) surgery were divided into two groups: (i) low-risk group (STS ≤0.5%; n=26) and (ii) intermediate-risk group (STS ≥2.0%; n=24). Plasma levels of selenium, glutathione peroxidase (GPx) and malondialdehyde (MDA) were measured in all patients at anaesthetic induction, after aortic cross-clamp removal, 3 h post cardiopulmonary bypass and on post-operative days 1 and 5. Multiple logistic regression was used to assess whether selenium levels were associated with POAF development.

Results: Seventeen patients developed POAF (14 patients in the intermediate-risk group and 3 patients in the low-risk group). Preoperative selenium was lower in patients who developed POAF compared with those with normal sinus rhythm (0.73±0.16 vs 0.89±0.13 μmol/l, P=0.005), and this was independently associated with POAF (PR 0.32; 95% confidence credible interval (95%cI) 0.06-0.85, P=0.016). Regardless of POAF, preoperative selenium was lower in the intermediate-risk patients than in the low-risk patients (0.77±0.15 vs 0.89±0.14 μmol/l; P=0.004).

Conclusions: Intermediate-risk patients with low preoperative selenium levels may be at a greater risk of developing POAF following CABG. This raises the question of whether selenium supplementation in select cardiac surgical patients may reduce their POAF risk.
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