Moderate-severe obesity increased the risk of postoperative atrial fibrillation in patients >50 years old (RR 2.3; 95% CI 1.71-3.13), while metabolic syndrome drove risk in those ≤50 years old.
Cohort (n=5,085)
Do obesity and metabolic syndrome increase the risk of new-onset postoperative atrial fibrillation in patients undergoing isolated CABG?
Obesity is a strong independent risk factor for postoperative atrial fibrillation after CABG in patients over 50, whereas metabolic syndrome is the primary metabolic risk factor in younger patients.
Effect estimate: RR 2.3 (95% CI 1.71-3.13)
p-value: p=<0.0001
BACKGROUND: Postoperative atrial fibrillation (POAF) is a highly prevalent complication after cardiac surgery with substantial effects on outcomes. Previous studies have reported that obesity is a risk factor for POAF after cardiac surgery. However, it is unknown whether the metabolic syndrome (MS) also increases the risk of postoperative atrial fibrillation. METHODS AND RESULTS: We retrospectively analyzed the association between obesity and MS and the incidence of new-onset POAF in a total of 5085 patients who underwent isolated coronary artery bypass grafting surgery with no concomitant valvular surgery. Of these patients, 1468 (29%) were obese (body mass index > or = 30 kg/m2) and 2320 (46%) had a MS as defined by the NCEP-ATPIII. POAF occurred in 1374 (27%) of the patients. Obesity was associated (P 50 years old but not in patients 50-year-old patients, mild (30 or = 35 kg/m2) obesity were independently associated with a 1.4-fold (95% CI: 1.10 to 1.71; P=0.004) and 2.3-fold (95% CI: 1.71 to 3.13; P<0.0001) increase in the risk of POAF, respectively. In < or = 50-year-old patients, MS (relative risk RR: 2.36; 95% CI: 1.10 to 5.12; P=0.02) but not obesity was independently associated with POAF. CONCLUSIONS: This study demonstrates that obesity is a powerful risk factor for the occurrence of POAF after isolated coronary artery bypass grafting surgery in patients older than 50 years. However, in the younger population, this association is not observed and MS is the only metabolic risk factor to be independently associated with POAF.
Echahidi et al. (Mon,) conducted a cohort in Postoperative atrial fibrillation (n=5,085). Obesity and Metabolic Syndrome vs. Non-obese and without Metabolic Syndrome was evaluated on New-onset postoperative atrial fibrillation (RR 2.3, 95% CI 1.71-3.13, p=<0.0001). Moderate-severe obesity increased the risk of postoperative atrial fibrillation in patients >50 years old (RR 2.3; 95% CI 1.71-3.13), while metabolic syndrome drove risk in those ≤50 years old.