Cardiometabolic index predicts postoperative atrial fibrillation after isolated CABG: ROC-based comparison with BMI and visceral adiposity indices

The assessment of visceral adipose tissue activity has gained significance in cardiac risk stratification. This study evaluates the predictive performance of novel visceral adiposity indices in determining the risk of postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting. Visceral adiposity indices were derived from anthropometric measurements and biochemical parameters collected during the preoperative period. The discriminative abilities of these indices were compared using receiver operating characteristic (ROC) curve analysis and their corresponding area under the curve (AUC) values. Univariate analysis revealed significant associations between the occurrence of postoperative atrial fibrillation and factors such as diabetes mellitus, a high EuroSCORE II, and extended cardiopulmonary bypass duration. Conversely, the visceral adiposity indices demonstrated substantial predictive value for postoperative atrial fibrillation. Notably, the cardiometabolic index (CMI) emerged as a significant predictor for the development of postoperative atrial fibrillation (OR: 4.054, 95% CI: 1.77-9.23; p=0.010). These findings indicate that CMI, a composite measure of visceral adiposity and metabolic dysfunction, may provide superior predictive performance for postoperative atrial fibrillation risk following isolated coronary artery bypass grafting compared to body mass index and visceral adiposity index, while showing comparable diagnostic value to the lipid accumulation product and body roundness index. Given the exploratory nature of this study, the suggested cutoff values should be interpreted cautiously and necessitate validation in diverse patient populations and larger cohorts prior to clinical implementation.