Key result
Intra-aortic balloon pump use (OR 3.001) and peripheral vascular disease (OR 2.450) were strong independent predictors of new-onset atrial fibrillation, which occurred in 28.57% of patients after off-pump coronary artery bypass grafting.
Why the study?
Risk factors and in-hospital complications of new-onset atrial fibrillation after off-pump coronary artery bypass grafting required exploration.
Observational (n=1,344)
No
Odds Ratio: 3.001 (95% CI 1.356–6.642)
p-value: p=0.007
New-onset atrial fibrillation occurs in nearly 30% of patients after off-pump CABG and is associated with significantly increased in-hospital morbidity and mortality.
May inform perioperative AF surveillance after off-pump CABG; hypothesis-generating for targeted prevention trials.
Objective To explore risk factors and in-hospital complications of new-onset atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). Methods In this study of 1344 patients who underwent isolated OPCAB from 2012 to 2015, patients were divided into AF and non-AF group according to whether new-onset postoperative AF occurred. Results The incidence of new-onset AF after OPCAB was 28.57%, mainly appeared within the first 4 days after surgery. After binary logistic regression analysis, age, peripheral vascular disease, median-sternotomy OPCAB, mechanical ventilation time, IABP were independent predictors of AF( p <0.001,OR 1.039,95%CI 1.023-1.055; p =0.007,OR 2.450,95%CI 1.282-4.684; p =0.044,OR 0.589,95%CI 0.351-0.987; p =0.013,OR 1.006,95%CI 1.001-1.011; p =0.007,OR 3.001,95%CI 1.356-6.642, respectively). Patients with AF have a significant higher risk of reoperation, re-entry into ICU, re-intubation, postoperative myocardial infarction, renal failure, and death ( p =0.013, p =0.015, p <0.001, p =0.037, p <0.001, p <0.001, respectively), also a longer re-ICU time ( p =0.014). Conclusion Advanced age, peripheral vascular disease, median-sternotomy OPCAB, mechanical ventilation time, IABP were independent predictors for new-onset AF after OPCAB. Postoperative AF was clearly associated with more in-hospital complications.
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Xu et al. (2020) conducted an observational in Isolated off-pump coronary artery bypass grafting (OPCAB) (n=1,344). Intra-aortic balloon pump (IABP) use vs. No IABP use was evaluated on New-onset atrial fibrillation (OR 3.001, 95% CI 1.356-6.642, p=0.007). Intra-aortic balloon pump use (OR 3.001) and peripheral vascular disease (OR 2.450) were strong independent predictors of new-onset atrial fibrillation, which occurred in 28.57% of patients after off-pump coronary artery bypass grafting.
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