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August 21, 2013Turkish Journal of Thoracic and Cardiovascular Surgery3 citations

Coronary vasculature and postoperative atrial fibrillation: a risk factor analysis

APAdıl Polat

Key Result

Left main coronary artery disease was identified as a significant independent risk factor for the development of postoperative atrial fibrillation after coronary artery bypass grafting (OR 13.3).

Study Design

Type

Observational (n=94)

Blinding

Single-blind

Multicenter

No

Structured PICO

What are the risk factors for postoperative atrial fibrillation in patients undergoing CABG?

P
Population
94 consecutive patients (mean age 61.4 years, 27.7% female) undergoing coronary artery bypass grafting, evaluated prospectively for risk factors of postoperative atrial fibrillation during their hospital stay.
E
Exposure
Risk factor analysis (perioperative parameters including Gensini score, Rentrop score, number of revascularized vessels, dominant coronary artery system, left main coronary artery disease, clinical status, left ventricular dysfunction, and left atrium diameter).
C
Comparator
Patients with vs. without postoperative atrial fibrillation.
O
Outcome
Occurrence of postoperative atrial fibrillation.hard clinical

Left ventricular dysfunction and left main coronary artery disease are significant risk factors for the development of postoperative atrial fibrillation following CABG.

Main Result

Odds Ratio: 13.3 (95% CI 1.5–114.5)

p-value: p=0.019

Limitations

  • Low number of patients (small sample size) which may have limited the identification of other significant results
  • Small patient sample limited the number of parameters that could be analyzed

Abstract

Background: This study aims to investigate the results of coronary artery bypass graft (CABG) surgeries in terms of the relation of postoperative atrial fibrillation, coronary vasculature, and the nature and extent of coronary artery disease. Methods: Between January 2011 and May 2011, 94 consecutive CABG patients (68 males, 26 females; mean age 61.4±10.9 years; range 38 to 87 years) who were operated in our clinic were enrolled in this prospective observational study. Logistic regression analysis was performed for the factors influencing the occurrence of postoperative atrial fibrillation. The perioperative parameters (Gensini score, Rentrop score, number of revascularized vessels, dominant coronary artery system, revascularization of the dominant coronary artery system, left main coronary artery disease, clinical status on admission, left ventricular dysfunction, and left atrium diameter) were analyzed as independent variables. Results: Twenty-three patients (24.5%) developed perioperative atrial fibrillation. Twenty patients returned to normal sinus rhythm with amiodarone therapy. In-hospital mortality was observed in three patients (3.2%). There was no statistically significant difference in mortality rates among the patients with and without atrial fibrillation. Left ventricular dysfunction (p=0.034) and left main coronary artery disease (p=0.019) were found to be significantly associated with the occurrence of postoperative atrial fibrillation. The rate of renal complications (p=0.030) and the need for sternal revision surgery (p=0.003) were not significantly different between both groups. Conclusion: Postoperative atrial fibrillation is a frequently encountered complication of cardiac surgery. The left ventricular dysfunction is a significant risk factor for postoperative occurrence of atrial fibrillation. Although no significant association between coronary vasculature and atrial fibrillation, the left main coronary artery disease is a serious risk factor for postoperative atrial fibrillation.

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Cite This Study

Adıl Polat (2013) conducted an observational in Coronary Artery Disease requiring CABG (n=94). Left main coronary artery disease vs. Absence of left main coronary artery disease was evaluated on Postoperative atrial fibrillation (OR 13.3, 95% CI 1.5-114.5, p=0.019). Left main coronary artery disease was identified as a significant independent risk factor for the development of postoperative atrial fibrillation after coronary artery bypass grafting (OR 13.3).

synapsesocial.com/papers/6a230d3c3bf314e836cb2c56https://doi.org/10.5606/tgkdc.dergisi.2013.7517
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