New-Onset Atrial Fibrillation Following Isolated Coronary Artery Bypass Grafting: Is Pulmonary Hypertension a Risk Factor?


AKÇA B., Erdil N.

Brazilian journal of cardiovascular surgery, vol.40, no.5, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 40 Issue: 5
  • Publication Date: 2025
  • Doi Number: 10.21470/1678-9741-2024-0352
  • Journal Name: Brazilian journal of cardiovascular surgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals
  • Keywords: Atrial Fibrillation, Coronary Artery Bypass, Hypertension, Pulmonary., Risk Factors
  • Inonu University Affiliated: Yes

Abstract

INTRODUCTION: This study aimed to clarify whether pulmonary hypertension is a risk factor for postoperative new-onset atrial fibrillation (NOAF) following isolated coronary artery bypass grafting (CABG). METHODS: Data of 4,782 patients were retrospectively examined from clinical database, and data of isolated CABG performed patients (n = 854) with preoperative echocardiography including pulmonary artery pressure (PAP) measurement were enrolled in study. While 115 patients had post-CABG NOAF (atrial fibrillation [AF] group), 739 did not have AF (non-AF group). Demographic, clinical, and treatment-related parameters were compared between groups, and independent clinical predictors of NOAF were identified by multivariate analysis. RESULTS: Patients of AF group were significantly older and had higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) points, significantly elevated mean systolic PAP, and more pulmonary hypertension. Multivariate regression analysis revealed that mean systolic PAP (odds ratio [OR]: 1.027, 95% confidence interval [CI]: 1.006 - 1.048) and pulmonary hypertension (≥ 30 mmHg; OR: 1.659, 95% CI: 1.093 - 2.518) were independent risk factors for post-CABG NOAF. Chronic obstructive pulmonary disease (COPD) (OR: 2.033, 95% CI: 1.265 - 3.268) and mean duration of ventilation support (OR: 1.059, 95% CI: 1.017 - 1.104) were additionally determined as risk factors for post-CABG NOAF. CONCLUSION: This study identified patients' age, high EuroSCORE points, presence of COPD, prolonged ventilation support, and increased PAP as predictors of post-CABG NOAF. Understanding the risk factors will provide better guidance in preventing this complication and its potential consequences. Prospective randomized controlled trials are required to further validate these findings and provide more robust evidence.