Preoperative LACI2 independently predicted postoperative atrial fibrillation after isolated CABG with OR 1.50 (95% CI 1.09–2.07, p=0.004) and an AUC of 0.690, surpassing LACI1.
Prospective cohort study (n=130)
No
Does preoperative Left Atrial Coupling Index predict postoperative atrial fibrillation in patients undergoing isolated CABG?
Preoperative Left Atrial Coupling Index, particularly the novel LACI2, is an independent predictor of postoperative atrial fibrillation after isolated CABG, which may aid in risk stratification.
Effect estimate: LACI1 OR 1.45; LACI2 OR 1.50 (95% CI LACI1 OR 1.06–1.98; LACI2 OR 1.09–2.07)
Absolute Event Rate: 45.4% vs 54.6%
p-value: p=LACI1 p=0.020; LACI2 p=0.004
Background and Objectives: Postoperative atrial fibrillation (POAF) is the most common arrhythmia after coronary artery bypass grafting (CABG) and is linked to adverse outcomes. This study evaluated the predictive value of the Left Atrial Coupling Index (LACI) for POAF and compared two calculation methods, LACI1 and the novel LACI2. Materials and Methods: This prospective study included 130 patients undergoing isolated CABG between January 2022 and June 2023. Preoperative echocardiography was performed to calculate conventional parameters and LACI values: LACI1 = LAVI/TDI-septal a′ and LACI2 = LAVI/min (TDI-septal a′, TDI-lateral a′). Patients were classified into POAF (+) and POAF (−) groups. Clinical, echocardiographic, and outcome data were compared. Logistic regression and receiver operating characteristic (ROC) analyses were performed. Results: POAF occurred in 59 patients (45.4%). Those with POAF were older, had more diabetes mellitus(DM), hypertension(HT), and higher EuroSCORE II values (all p < 0.05). POAF was associated with longer hospitalization and higher in-hospital mortality. Both LACI1 (4.21 ± 2.62 vs. 2.94 ± 1.02, p < 0.001) and LACI2 (4.27 ± 2.60 vs. 2.96 ± 1.02, p < 0.001) were significantly higher in the POAF group. In multivariate analysis, LACI1 (OR 1.45, p = 0.020) and LACI2 (OR 1.50, p = 0.004) remained independent predictors. ROC analysis showed numerically higher discriminatory performance for LACI2 (AUC = 0.690, specificity 74.5%) compared with LACI1 (AUC = 0.677, specificity 67.6%). Conclusions: LACI is an independent predictor of POAF after CABG. The novel LACI2 demonstrated numerically higher predictive performance compared with LACI1 and may improve preoperative risk stratification and guide preventive strategies.
Sinoplu et al. (2026) conducted a prospective cohort study in Adults aged 18 to 80 years undergoing isolated coronary artery bypass grafting (CABG) without prior atrial fibrillation, congenital valvular disease, or valvular pathology requiring intervention (n=130). Assessment of Left Atrial Coupling Index (LACI) as a predictive biomarker vs. Patients without elevated LACI was evaluated on Incidence of postoperative atrial fibrillation (POAF) detected by ECG or telemetry irrespective of duration (LACI1 OR 1.45; LACI2 OR 1.50, 95% CI LACI1 OR 1.06–1.98; LACI2 OR 1.09–2.07, p=LACI1 p=0.020; LACI2 p=0.004). Preoperative LACI2 independently predicted postoperative atrial fibrillation after isolated CABG with OR 1.50 (95% CI 1.09–2.07, p=0.004) and an AUC of 0.690, surpassing LACI1.