F. Dastan (Tehran TR)
Aim: Atrial Fibrillation [AF] is one of the most common complications in patients who undergo coronary artery bypass graft surgery [CABG]. The aim of this study was to evaluate the effect of L-carnitine administration on postoperative AF and acute kidney injury following CABG.
Design & methods: One hundred and thirty four patients undergoing elective CABG, without history of AF or previous L-carnitine treatment, were randomly assigned to an L-carnitine group (3000 mg/day L-carnitine) or a control group. CRP levels, as a biomarker of inflammation, were assessed in all the patients before surgery as baseline levels and 48 hours postoperatively. Neutrophil gelatinase-associated lipocalin (NGAL), as a kidney biomarker, was also measured in the patients before surgery and 2 hours thereafter.
Results: The incidence of AF was 13.4% in our population. L-carnitine significantly reduced the incidence of postoperative AF (7.5% in the L-carnitine group vs. 19.4% in the control group; p value=0.043) and postoperative CRP level (8.79±6.9 in the L-carnitine group vs. 10.83±5.7 in the control group; p value=0.021). Postoperative NGAL concentration demonstrated no significant rise after surgery compared with the preoperative concentration (72.54±20.30 in the L-carnitine group vs. 67.68±22.71 in the placebo group; p value=0.19).
Conclusions: Our study showed that L-carnitine administration before CABG may inhibit and reduce the incidence of post-CABG AF. It seems that a rise in the CRP level, as an inflammation marker, may be associated with the incidence of AF.