Preoperative inflammatory profile in chronic coronary syndrome reveals interleukin-2 as a promising biomarker for postoperative atrial fibrillation risk stratification

Introduction: Inflammation plays a central role in the development of postoperative atrial fibrillation (POAF). However, the influence of preoperative inflammatory status on POAF has not been thoroughly investigated. Our objective was to evaluate the impact of preoperative inflammatory markers on POAF occurrence in patients undergoing elective coronary artery bypass grafting (CABG). Methods: We conducted a prospective study on 102 patients scheduled for elective CABG. Continuous 24-hour Holter ECG monitoring was performed preoperatively (day -1) and postoperatively (days 2-4). Venous blood samples were collected one day before surgery to measure highly sensitive C-reactive protein, transforming growth factor-β, von Willebrand factor, and interleukins (IL)-1β, IL-2, IL-6, and IL-8. The predictive value of these biomarkers for POAF was evaluated using univariate and multivariate logistic regression analyses. Results: . 2 [2-4] points, p < 0.0001). In multiple logistic regression analysis, age ≥ 62 years, diabetes mellitus, and SYNTAX score ≥ 26 independently predicted higher POAF risk (p ≤ 0.01), while IL-2 level ≥ 3.7 pg/mL was associated with decreased POAF likelihood (OR 0.07, 95% CI [0.01-0.3], p < 0.001). Conclusions: POAF is a common post-CABG arrhythmia. Decreased preoperative IL-2 concentrations represent an independent prognostic biomarker for POAF with important clinical significance. These findings suggest IL-2 as a promising biomarker for POAF risk stratification in the perioperative CABG population.