{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:49:10Z","timestamp":1790023750810,"version":"4.0.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008723","name":"Finnish Medical Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008723","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Finnish Foundation for Cardiovascular Research, and the State Clinical Research Fund (EVO) of Turku University Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Cardiac surgery and the use of cardiopulmonary bypass (CPB) lead to short-lasting postoperative inflammatory response and some patients fail to adapt to the stress leading to a prolonged systemic inflammatory response syndrome (SIRS). We aimed to identify the risk factors for prolonged SIRS and whether this may affect the onset of short- and long-term postoperative atrial fibrillation (AF) after adult cardiac surgery patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The CAREBANK biobank study consists of prospectively enrolled patients undergoing adult cardiac surgery from 2016 to 2021 with ongoing follow-up data. This substudy included patients operated on with or without the use of CPB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 982 patients underwent cardiac surgery, 824 (84%) patients using CPB. Prolonged SIRS was observed in 62 (6.3%) patients. Transfusion of packed red blood cells (OR 1.9, 95%, confidence interval [CI] 1.1-3.5, P\u2009=\u2009.03), and the first postoperative day C-reactive protein level (OR 1.2, 95%, CI 1.0-1.3, per 10 units, P\u2009=\u2009.002) were associated with the development of prolonged SIRS in a multivariable analysis. Patients with prolonged SIRS had more adverse events during index hospitalization, mainly driven by the higher incidence of postoperative AF compared to non-SIRS patients (OR 2.4, 95%, CI, 1.4-4.0, P\u2009&amp;lt;\u2009.001). At 2\u2009years, the incidence of post-discharge AF was higher compared with non-SIRS patients (hazard ratio 2.0, 95% CI, 1.1-3.6, P\u2009=\u2009.024).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A subset of cardiac surgery patients demonstrates impaired adaptation to the perioperative inflammatory response, placing them at increased risk for AF both early after surgery and following discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical registration number<\/jats:title>\n                    <jats:p>NCT03444259<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag081","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T15:43:08Z","timestamp":1773330188000},"source":"Crossref","is-referenced-by-count":1,"title":["Prolonged Systemic Inflammatory Response Syndrome Predicts Atrial Fibrillation After Cardiac Surgery"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4337-5825","authenticated-orcid":false,"given":"Emma","family":"Viikinkoski","sequence":"first","affiliation":[{"name":"Heart Center, Turku University Hospital and University of Turku , FI-20521 Turku,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6420-8607","authenticated-orcid":false,"given":"Joonas","family":"Lehto","sequence":"additional","affiliation":[{"name":"Heart Center, Turku University Hospital and University of Turku , FI-20521 Turku,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2177-5900","authenticated-orcid":false,"given":"Arto","family":"Relander","sequence":"additional","affiliation":[{"name":"Heart Center, Turku University Hospital and University of Turku , FI-20521 Turku,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1693-8293","authenticated-orcid":false,"given":"Juho","family":"Jalkanen","sequence":"additional","affiliation":[{"name":"MediCity Research Laboratory, Department of Microbiology and Immunology, InFLAMES Flagship, University of Turku , FI-20014 Turku,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6996-0726","authenticated-orcid":false,"given":"Jarmo","family":"Gunn","sequence":"additional","affiliation":[{"name":"Heart Center, Turku University Hospital and University of Turku , FI-20521 Turku,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1862-8133","authenticated-orcid":false,"given":"Tuija","family":"Vasankari","sequence":"additional","affiliation":[{"name":"Heart Center, Turku University Hospital and University of Turku , FI-20521 Turku,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-8186","authenticated-orcid":false,"given":"Fausto","family":"Biancari","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS , 20138 Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0193-568X","authenticated-orcid":false,"given":"Juhani K E","family":"Airaksinen","sequence":"additional","affiliation":[{"name":"Heart Center, Turku University Hospital and University of Turku , FI-20521 Turku,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3250-7653","authenticated-orcid":false,"given":"Maija","family":"Hollm\u00e9n","sequence":"additional","affiliation":[{"name":"MediCity Research Laboratory, Department of Microbiology and Immunology, InFLAMES 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