Postoperative atrial fibrillation: role of inflammatory biomarkers and use of colchicine for its prevention

Abstract

Postoperative atrial fibrillation (POAF) is the most common complication following cardiac surgery, occurring in up to 65% of cardiac surgical patients. It is a condition associated with increased morbidity, increased length of hospital stay, and increased health care costs. One of the many potential causes of POAF is postsurgical inflammation, as demonstrated by increased levels of inflammatory biomarkers such as C-reactive protein and interleukin-6. Although still a subject of debate, the role of these inflammatory markers in the pathogenesis of POAF remains under vigorous investigation. Several antiinflammatory drugs have demonstrated promising results in prevention of POAF, including nonsteroidal antiinflammatory drugs, glucocorticoids, and statins. Colchicine is one of the oldest medications used in modern medicine, typically for the treatment and prevention of gout. New evidence has recently surfaced that colchicine may also be useful in the prevention of POAF. In recent studies, colchicine has demonstrated both safety and efficacy in the prevention of POAF. Several new studies are currently being initiated that may further elucidate colchicine's role in the prevention of POAF.

Keywords: C-reactive protein; atrial fibrillation; biomarkers; cardiac surgery; colchicine; inflammation; interleukin-6; pericarditis; postoperative atrial fibrillation.