Circulating levels of ferritin, RDW, PTLs as predictive biomarkers of postoperative atrial fibrillation risk after cardiac surgery in extracorporeal circulation

Postoperative atrial fibrillation (POAF) is the most common arrhythmia after cardiac surgery in conventional extracorporeal circulation (CECC), with an incidence of 15–50%. The POAFpathophysiology is not known, and no blood biomarkers exist. However, an association between increasedferritin levels and increased AF risk, has been demonstrated. Based on such evidence, here, weevaluated the effectiveness of ferritin and other haematological parameters as POAF risk biomarkersin patients subjected to cardiac surgery. We enrolled 105 patients (mean age = 70.1   7.1 years; 70 menand 35 females) with diverse heart pathologies and who were subjected to cardiothoracic surgery.Their blood samples were collected and used to determine hematological parameters. Electrocardiographicand echocardiographic parameters were also evaluated. The data obtained demonstratedsignificantly higher levels of serum ferritin, red cell distribution width (RDW), and platelets (PLTs) inPOAF patients. However, the serum ferritin resulted to be the independent factor associated with theonset POAF risk. Thus, we detected the ferritin cut-off value, which, when  148.5 ng/mL, identifiesthe subjects at the highest POAF risk, and with abnormal ECG atrial parameters, such as PW indices,and altered structural heart disease variables. Serum ferritin, RDW, and PTLs represent predictivebiomarkers of POAF after cardiothoracic surgery in CECC; particularly, serum ferritin combinedwith anormal PW indices and structural heart disease variables can represent an optimal tool forpredicting not only POAF, but also the eventual stroke onset.