Oxidative Stress in Postoperative Atrial Fibrillation: Does Malondialdehyde Hold Predictive Value?
<i>Background and Objectives</i>: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, associated with increased morbidity and prolonged hospital stays. Oxidative stress has been implicated in POAF pathogenesis, with malondialdehyde (MDA), a marker...
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MDPI AG
2025-04-01
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| author | Urska Intihar Arta Krasniqi Anze Djordjevic Jan Zmazek Harun Avdagic Jus Ksela Miha Antonic |
| author_facet | Urska Intihar Arta Krasniqi Anze Djordjevic Jan Zmazek Harun Avdagic Jus Ksela Miha Antonic |
| author_sort | Urska Intihar |
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| description | <i>Background and Objectives</i>: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, associated with increased morbidity and prolonged hospital stays. Oxidative stress has been implicated in POAF pathogenesis, with malondialdehyde (MDA), a marker of lipid peroxidation, proposed as a potential biomarker. However, conflicting evidence exists regarding its predictive value. This study aimed to assess the association between serum MDA levels and POAF incidence in patients undergoing cardiac surgery. <i>Materials and Methods</i>: This prospective observational study included 99 consecutive patients undergoing elective on-pump cardiac surgery. Patients with preoperative atrial fibrillation, chronic kidney disease requiring dialysis, or emergency surgery were excluded. Blood samples for MDA measurement were collected at six perioperative time points: preoperatively, intraoperatively after aortic clamp release, and at 8, 24, 48, and 72 h postoperatively. Patients were monitored for new-onset POAF during the first three postoperative days. Statistical analyses included independent samples <i>t</i>-tests, Mann–Whitney U-tests, and Fisher’s exact tests, with significance set at <i>p</i> < 0.05. <i>Results</i>: POAF occurred in 33 (33%) patients. Patients who developed POAF were significantly older (<i>p</i> = 0.017) and had higher EuroSCORE II values (<i>p</i> = 0.019). No significant differences were observed in serum MDA concentrations between POAF and non-POAF patients at any measured time point. The incidence of POAF was higher in patients undergoing valvular surgery (<i>p</i> = 0.014). <i>Conclusions</i>: Serum MDA levels were not associated with POAF development, suggesting that lipid peroxidation alone may not play a central role in POAF pathogenesis. These findings challenge the predictive value of MDA for POAF risk stratification. Future research should explore alternative oxidative stress markers and their potential therapeutic implications in POAF prevention. |
| format | Article |
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| institution | OA Journals |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj-art-0727f04ca8bf4aa6af55f03f431433912025-08-20T01:56:19ZengMDPI AGMedicina1010-660X1648-91442025-04-0161577810.3390/medicina61050778Oxidative Stress in Postoperative Atrial Fibrillation: Does Malondialdehyde Hold Predictive Value?Urska Intihar0Arta Krasniqi1Anze Djordjevic2Jan Zmazek3Harun Avdagic4Jus Ksela5Miha Antonic6Department of Cardiac Surgery, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, SloveniaDepartment of Cardiac Surgery, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, SloveniaDepartment of Cardiac Surgery, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, SloveniaFaculty of Natural Sciences and Mathematics, University of Maribor, 2000 Maribor, SloveniaDepartment of Cardiovascular Surgery, University Medical Centre Tuzla, 75000 Tuzla, Bosnia and HerzegovinaDepartment of Cardiovascular Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, SloveniaDepartment of Cardiac Surgery, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia<i>Background and Objectives</i>: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, associated with increased morbidity and prolonged hospital stays. Oxidative stress has been implicated in POAF pathogenesis, with malondialdehyde (MDA), a marker of lipid peroxidation, proposed as a potential biomarker. However, conflicting evidence exists regarding its predictive value. This study aimed to assess the association between serum MDA levels and POAF incidence in patients undergoing cardiac surgery. <i>Materials and Methods</i>: This prospective observational study included 99 consecutive patients undergoing elective on-pump cardiac surgery. Patients with preoperative atrial fibrillation, chronic kidney disease requiring dialysis, or emergency surgery were excluded. Blood samples for MDA measurement were collected at six perioperative time points: preoperatively, intraoperatively after aortic clamp release, and at 8, 24, 48, and 72 h postoperatively. Patients were monitored for new-onset POAF during the first three postoperative days. Statistical analyses included independent samples <i>t</i>-tests, Mann–Whitney U-tests, and Fisher’s exact tests, with significance set at <i>p</i> < 0.05. <i>Results</i>: POAF occurred in 33 (33%) patients. Patients who developed POAF were significantly older (<i>p</i> = 0.017) and had higher EuroSCORE II values (<i>p</i> = 0.019). No significant differences were observed in serum MDA concentrations between POAF and non-POAF patients at any measured time point. The incidence of POAF was higher in patients undergoing valvular surgery (<i>p</i> = 0.014). <i>Conclusions</i>: Serum MDA levels were not associated with POAF development, suggesting that lipid peroxidation alone may not play a central role in POAF pathogenesis. These findings challenge the predictive value of MDA for POAF risk stratification. Future research should explore alternative oxidative stress markers and their potential therapeutic implications in POAF prevention.https://www.mdpi.com/1648-9144/61/5/778postoperative atrial fibrillationoxidative stressmalondialdehydelipid peroxidationcardiac surgerybiomarker |
| spellingShingle | Urska Intihar Arta Krasniqi Anze Djordjevic Jan Zmazek Harun Avdagic Jus Ksela Miha Antonic Oxidative Stress in Postoperative Atrial Fibrillation: Does Malondialdehyde Hold Predictive Value? Medicina postoperative atrial fibrillation oxidative stress malondialdehyde lipid peroxidation cardiac surgery biomarker |
| title | Oxidative Stress in Postoperative Atrial Fibrillation: Does Malondialdehyde Hold Predictive Value? |
| title_full | Oxidative Stress in Postoperative Atrial Fibrillation: Does Malondialdehyde Hold Predictive Value? |
| title_fullStr | Oxidative Stress in Postoperative Atrial Fibrillation: Does Malondialdehyde Hold Predictive Value? |
| title_full_unstemmed | Oxidative Stress in Postoperative Atrial Fibrillation: Does Malondialdehyde Hold Predictive Value? |
| title_short | Oxidative Stress in Postoperative Atrial Fibrillation: Does Malondialdehyde Hold Predictive Value? |
| title_sort | oxidative stress in postoperative atrial fibrillation does malondialdehyde hold predictive value |
| topic | postoperative atrial fibrillation oxidative stress malondialdehyde lipid peroxidation cardiac surgery biomarker |
| url | https://www.mdpi.com/1648-9144/61/5/778 |
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