Predicting postoperative atrial fibrillation after myocardial revascularization without cardiopulmonary bypass: A retrospective cohort study.

Abstract

INTRODUCTION:

Considering the threat imposed by postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) and the potential benefits of off-pump CABG, the objective of this study was to describe the incidence and identify predictor factors for POAF in patients undergoing CABG without cardiopulmonary bypass (CPB).

METHODS:

In this retrospective cohort study, we enrolled patients undergoing CABG without CPB between December 2008 and December 2011. The independent variables evaluated in this study were major patients' characteristics (age, sex, and ethnia), associated comorbidities (systemic arterial hypertension, diabetes mellitus, thyroid dysfunction, chronic renal failure (CRF), chronic obstructive pulmonary disease, and ischemic stroke), and the revascularization approach (the number of grafts used, the revascularized branch, and the choice of vascular graft (arterial or venous). The dependent variable was the onset of atrial fibrillation after the procedure.

RESULTS:

Two hundred and eighty patients were included in the present study. The overall incidence of POAF after off-pump CABG was 5.0%. In the univariate analysis, the presence of chronic renal failure (odds ratio [OR], 3.01 [1.00-9.06], P = .049) and the use of venous-origin graft alone (OR, 9.67 [1.15-81.56], P = .037) were associated with an increased risk or POAF. These findings were confirmed after multivariate analysis, for both CRF (OR, 3.31 [1.05-10.46], P = .042) and the use of venous-origin graft alone (OR, 9.81 [1.13-85.35], P = .039).

CONCLUSION:

Off-pump coronary artery bypass grafting proved a safe and effective procedure, with low postoperative atrial fibrillation occurrence, for myocardial revascularization. Chronic renal insufficiency and the use of venous-origin graft solely proved to be independent predictor factors for PAOF.

• Authors: Edgar Vidotti, Lisia F K Vidotti, Camila A G Arruda Tavares, Érica D Z Ferraz, Vagner Oliveira, Augusto G de Andrade, Janaina M B Cardoso, Márcio H Cardoso
• Journal: Journal of cardiac surgery (J Card Surg) Vol. 34 Issue 7 Pg. 577-582 (Jul 2019) ISSN: 1540-8191 [Electronic] United States
• PMID: 31212388 (Publication Type: Journal Article)
• Copyright: © 2019 Wiley Periodicals, Inc.

Topics

• Aged
• Atrial Fibrillation (epidemiology, prevention & control)
• Cardiopulmonary Bypass
• Cohort Studies
• Coronary Artery Bypass, Off-Pump
• Female
• Forecasting
• Humans
• Male
• Middle Aged
• Myocardial Revascularization (methods)
• Postoperative Complications (epidemiology, prevention & control)
• Retrospective Studies
• Treatment Outcome