Atrial fibrillation after coronary artery bypass grafting in elderly patients: Incidence and risk factor analysis

Nisanoglu V., Erdil N., Aldemir M., Ozgur B., Cihan H. B., Yologlu S., ...More

THORACIC AND CARDIOVASCULAR SURGEON, vol.55, no.1, pp.32-38, 2007 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 55 Issue: 1
  • Publication Date: 2007
  • Doi Number: 10.1055/s-2006-924711
  • Journal Name: THORACIC AND CARDIOVASCULAR SURGEON
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.32-38
  • Keywords: cardiovascular surgery, coronary bypass surgery, heart disease, CARDIAC-SURGERY, PREDICTORS, AMIODARONE, COMPLICATIONS, MORTALITY, STAY
  • Inonu University Affiliated: Yes

Abstract

Objective: New-onset atrial fibrillation (AF) is the most frequent arrhythmic complication after coronary artery bypass grafting (CABG). Elderly patients who undergo this operation may have a different risk profile from the general population. The aim of this study was to identify risk factors for post-CABG AF in the elderly population. Methods: Between September 2001 and December 2005, 426 elderly patients (age 65 years) underwent CABG at our center. Ninety-one developed post-CABG AF (AF group), and the other 335 (no-AF group) did not develop this complication. Multivariate analysis (odds ratio, +/- 95% Cl, p value) was used to identify independent clinical predictors of post-CABG AF. Results: The incidence of post-CABG AF in elderly patients during the study period was 21.4%. Multivariate analysis identified age (OR 1.07, p < 0.009), age >= 75 years (OR 1.77, p < 0.042), preoperative renal insufficiency (OR 5.09, p < 0.035), EuroSCORE (OR 1.18, p < 0.038), and cross-clamping time (OR 1.02, p < 0.012) as predictors of AF occurrence. The AF group had a significantly longer mean intensive care unit (ICU) stay (3.8 +/- 4.7 vs. 2.5 +/- 1.3 days for AF vs. no-AF; p = 0.0001), and a significantly higher proportion of patients with prolonged ( >= 6 days) ICU stays (8.8% vs. 3.2%, respectively; p=0.033). Hospital mortality was 3.2% in the no-AF group and 2.2% in the AF group (p = 0.74). Conclusion: This study of elderly patients reveals some novel predictors of post-CABG AF, most notably preoperative renal insufficiency and EuroSCORE. It is important to identify risk factors for post-CABG AF in all patient groups as this knowledge might lead to better prevention of this problem and its potential consequences.