Marijana Tadic, Branislava Ivanovic, Nevenka Zivkovic
Med Sci Monit 2011; 17(1): CR48-55
Background: New-onset atrial fibrillation is the most common form of rhythm disturbance following coronary artery bypass grafting surgery (CABG). It is still unclear which factors have a significant impact on its occurrence after this procedure. The aim of this study was to evaluate clinical predictors of postoperative atrial fibrillation (POAF) after myocardial revascularization.
Material/Methods: We performed a retrospective analysis of 322 patients who underwent the first CABG operation without baseline atrial fibrillation. All subjects underwent laboratory blood tests, echocardiography and selective coronarography with ventriculography. Patients were continuously electrocardiographically monitored during the first 48-72h after the operation for the occurrence of POAF.
Results: POAF was diagnosed in 72 (22.4%) of the patients. Multivariate logistic regression analysis was used to identify the following independent clinical predictors of POAF: age ≥65 years (OR 1.78; 95%CI: 1.06–2.76; p=0.043), hypertension (OR 1.97; 95%CI: 1.15–3.21; p=0.018), diabetes mellitus (OR 2.09; 95% CI: 1.31–5.33; p=0.010), obesity (OR 1.51; 95%CI: 1.03–3.87; p=0.031), hypercholesterolemia (OR 2.17, 95%CI: 1.05–4.25; p=0.027), leukocytosis (OR 2.32, 95%CI: 1.45–5.24; p=0.037), and left ventricular segmental kinetic disturbances (OR 3.01; 95%CI: 1.65–4.61, p<0.001).
Conclusions: This study demonstrates that advanced age, hypertension, diabetes, obesity, hypercholesterolemia, leukocytosis, and segmental kinetic disturbances of the left ventricle are powerful risk factors for the occurrence of POAF.
Keywords: Postoperative Complications - etiology, Obesity - complications, Logistic Models, Leukocytosis - complications, Hypertension - complications, Hypercholesterolemia - complications, Humans, Diabetes Mellitus, Type 2 - complications, Coronary Artery Bypass - adverse effects, Atrial Fibrillation - etiology, Adult, Age Factors, Retrospective Studies, Serbia, Ventricular Dysfunction, Left - complications