General thoracic and cardiovascular surgery · 2017
Prognostic factors of atrial fibrillation following coronary artery bypass graft surgery.
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Kievišas Mantas, Keturakis Vytenis, Vaitiekūnas Egidijus, Dambrauskas Lukas, Jankauskienė Loreta, Kinduris Šarūnas
Аннотация
OBJECTIVE: Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery. To prevent this complication, routine pharmacological prophylactic drugs could be administered. Our study aimed to analyze the various perioperative factors associated with the development of POAF after coronary artery bypass graft (CABG) surgery.
METHODS: This prospective study included 617 patients, who received CABG surgery in the year 2014.
RESULTS: There were 429 (69.5%) male and 188 (30.5%) female patients. Mean patient age was 67.2 (9.4) years, and 365 patients (59.2%) were more than 65 years. Incidence of POAF was 24.1% (N = 149). Multivariable analysis showed that independent predictors of POAF after CABG surgery were: age >65 (P = 0.008; OR 2.089; 95% CI 1.208-3.613), AF in the past (P < 0.001; OR 10.838; 95% CI 5.28-22.247), preoperative hypertrophy or dilation of left atrium (P = 0.002; OR 4.996; 95% CI 1.823-13.691), CABG surgery using 4 or more bypass grafts (P = 0.042; OR 1.669; 95% CI 0.972-2.866), preoperative hypokalemia (P = 0.001; OR 3.317; 95% CI 1.678-6.559), >trivial mitral (P = 0.024; OR 7.556; 95% CI 0.964-20.376), and aortic (P = 0.009; OR 1.937; 95% CI 1.178-3.187) valve regurgitation.
CONCLUSIONS: The profile of patients affected by POAF was considerably different with regard to the demographics, preoperative heart condition, history of previous heart rhythm disorders, and operative data. The most important independent factors that predicted POAF after CABG surgery were associated with structural heart defects, advanced age, history of previous AF, and preoperative hypokalemia.
METHODS: This prospective study included 617 patients, who received CABG surgery in the year 2014.
RESULTS: There were 429 (69.5%) male and 188 (30.5%) female patients. Mean patient age was 67.2 (9.4) years, and 365 patients (59.2%) were more than 65 years. Incidence of POAF was 24.1% (N = 149). Multivariable analysis showed that independent predictors of POAF after CABG surgery were: age >65 (P = 0.008; OR 2.089; 95% CI 1.208-3.613), AF in the past (P < 0.001; OR 10.838; 95% CI 5.28-22.247), preoperative hypertrophy or dilation of left atrium (P = 0.002; OR 4.996; 95% CI 1.823-13.691), CABG surgery using 4 or more bypass grafts (P = 0.042; OR 1.669; 95% CI 0.972-2.866), preoperative hypokalemia (P = 0.001; OR 3.317; 95% CI 1.678-6.559), >trivial mitral (P = 0.024; OR 7.556; 95% CI 0.964-20.376), and aortic (P = 0.009; OR 1.937; 95% CI 1.178-3.187) valve regurgitation.
CONCLUSIONS: The profile of patients affected by POAF was considerably different with regard to the demographics, preoperative heart condition, history of previous heart rhythm disorders, and operative data. The most important independent factors that predicted POAF after CABG surgery were associated with structural heart defects, advanced age, history of previous AF, and preoperative hypokalemia.