Incidence and risk factor analysis of atrial fibrillation after coronary artery bypass grafting

Background Postoperative atrial fibrillation (AF) is a common arrhythmia after coronary artery bypass grafting (CABG). It seriously affects the recovery of postoperative cardiac function, and may even lead to stroke, prolonged hospital stays, increased medical costs, and increased mortality. The relevant risk factors have not reached a consensus. Objective To evaluate the incidence of AF after CABG and analyze its risk factors. Methods Clinical data of 358 patients who underwent CABG in our hospital from December 2023 to January 2025 were retrospectively collected. Patients were divided into an AF group and a non-AF group according to the occurrence of AF during hospitalization after surgery (within 1-3 weeks). The clinical data of the two groups were compared and statistically analyzed to screen the incidence of AF after CABG and analyze its independent risk factors. Results Among 358 patients, 25.4% (91/358) developed AF after CABG. Univariate analysis revealed significant differences (p < 0.001) in 10 factors between AF and non-AF groups: advanced age (>70 years), smoking history, hypertension history, AF history, early β-blocker discontinuation, ACEI/ARB use, LVEF value, LAD≥40mm, preoperative P-wave duration ≥120 ms, and >3 vessel grafts. Multivariate regression identified 9 independent risk factors: advanced age (OR 3.376, 95%CI 1.880 - 6.063), smoking (OR 1.362, 95%CI 1.125 - 1.637), early β-blocker stop (OR 6.712, 95%CI 3.058 - 14.734), ACEI/ARB use (OR 1.294, 95%CI 1.073 - 1.558), hypertension (OR 2.924, 95%CI 1.523 - 5.615), LVEF value (OR 1.117, 95%CI 1.028 - 1.279), LAD≥40mm (OR 2.378, 95%CI 1.301 - 4.345), >3 vessel grafts (OR 1.052, 95%CI 1.010 - 1.132), and AF history (OR 8.426, 95%CI 1.539 - 29.723). Conclusion Advanced age (>70 years), smoking history, early postoperative discontinuation of β-blockers, use of ACEI/ARB drugs, hypertension, LVEF value, LAD≥40mm, number of vessel grafts >3, and history of AF are independent risk factors for AF after CABG. Exploration of risk factors related to AF after CABG has important clinical value, which helps to prevent and reduce AF and complications after CABG, promote patient recovery and improve prognosis.