Key result
Advanced age (OR 1.05) and higher BMI (OR 1.095) independently increased the risk of post-operative atrial fibrillation in patients undergoing cardiac surgery without previous atrial fibrillation.
Why the study?
BMI, age, LA dimensions, and LVEF have been linked to post-operative atrial fibrillation after cardiac surgery, but the specific role of these risk factors required better definition.
Do advanced age and higher BMI increase the risk of post-operative atrial fibrillation in patients undergoing cardiac surgery without prior atrial dysrhythmia?
Cohort (n=249)
No
Do advanced age and higher BMI increase the risk of post-operative atrial fibrillation in patients undergoing cardiac surgery without prior atrial dysrhythmia?
Advanced age and higher BMI are independent risk factors for post-operative atrial fibrillation after cardiac surgery, regardless of left atrial size and left ventricular ejection fraction.
Supports incorporating age and BMI into POAF risk models; leaves open whether modification alters outcomes after cardiac surgery.
Background : Body mass index (BMI), age, left atrium (LA) dimensions and left ventricular ejection fraction (LVEF) have been linked to post-operative atrial fibrillation (POAF) after cardiac surgery. The aim was to better define the role of these risk factors. Methods : This study evaluated 249 patients (without prior atrial dysrhythmia) undergoing cardiac or aortic surgery . Prior to surgery the following data were collected: age (yrs), BMI (kg/m2), LA diameter (cm), LA area (cm2), LVEF (%), the presence of arterial hypertension (AH) and of diabetes, tyroid stimulating hormone (TSH, mU/L) and, creatinine (mg/dL). Results : Patients with (n. 127, 51%) and without POAF (n. 122, 49%) were compared. No difference was observed for sex, LA diameter, LA area, LVEF, TSH and diabetes. Instead, patients with PoAF had higher values of age, BMI, creatinine and a greater prevalence of AH and Bentall procedures. Multivariable analysis showed that the only independent predictors of PoAF were: age (OR = 1,05, CI 95% 1,025-1,076, p= 0,0001) and BMI (OR=1,095, CI 95% 1,015-1,182, p= 0,019). Conclusions : Results suggest that advanced age and a higher value of BMI are strong risk factors for POAF in patients without previous AF. This even in the presence of comparable LA dimensions and LVEF.
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Stefàno et al. (2020) conducted a cohort in Cardiac or aortic surgery (n=249). Higher Body Mass Index (BMI) vs. Lower Body Mass Index (BMI) was evaluated on Incident post-operative atrial fibrillation (POAF) (OR 1.095, 95% CI 1.015-1.182, p=0.019). Advanced age (OR 1.05) and higher BMI (OR 1.095) independently increased the risk of post-operative atrial fibrillation in patients undergoing cardiac surgery without previous atrial fibrillation.
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