Background:  Postoperative atrial fibrillation (POAF) is associated with major morbidities and mortality with its exact mechanism still not fully illustrated.
Objectives: The effect of preoperative vitamin supplemental therapy (VST) on serum levels of vitamin D (VD), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), malonaldehyde (MDA), and superoxide dismutase (SOD), and on outcomes of patients undergoing coronary artery bypass graft (CABG) especially the incidence of postoperative atrial fibrillation (POAF).
Patients and methods: 124 patients scheduled for elective on-pump isolated CABG surgery were clinically evaluated. Three blood samples (S1-S3); before and after VST and after aortic declamping for estimation of serum levels of 25-hydroxy VD, IL-6, hsCRP, MDA, and SOD. Patients were randomly divided into the Control group (Group C) that did not receive VST and the Study group (Group S) that received VST for four weeks. Study outcomes included POAF incidence, the change of serum levels of estimated variables in S2 and S3 concerning the S1 sample, and the relation between receiving VST and these changes.
Results: Amount of chest tube drainage, the incidence of POAF and the total duration of PO hospital stay were significantly less in Group S than in Group C.VST significantly reduced serum MDA and hsCRP levels with a significantly elevated serum SOD levels in S2 than S1 samples. Preoperative VST is negative, while prolonged cardiopulmonary bypass time, high serum levels of IL-6 and hsCRP, and low serum levels of SOD in the S3 samples as significant positive predictors for POAF development.
Conclusion: Reduced serum inflammatory cytokines' levels with improved levels of SOD by preoperative VST are significant predictors for decreased POAF incidence and improved CABG outcome.