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Atrial fibrillation after coronary artery bypass grafting in elderly patients: incidence and risk factor analysis.
Thorac Cardiovasc Surg. 2007 Feb; 55(1):32-8.TC

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 % CI, 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.

Authors+Show Affiliations

Department of Cardiovascular Surgery, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey. vnisanoglu@inonu.edu.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17285471

Citation

Nisanoglu, V, et al. "Atrial Fibrillation After Coronary Artery Bypass Grafting in Elderly Patients: Incidence and Risk Factor Analysis." The Thoracic and Cardiovascular Surgeon, vol. 55, no. 1, 2007, pp. 32-8.
Nisanoglu V, Erdil N, Aldemir M, et al. Atrial fibrillation after coronary artery bypass grafting in elderly patients: incidence and risk factor analysis. Thorac Cardiovasc Surg. 2007;55(1):32-8.
Nisanoglu, V., Erdil, N., Aldemir, M., Ozgur, B., Berat Cihan, H., Yologlu, S., & Battaloglu, B. (2007). Atrial fibrillation after coronary artery bypass grafting in elderly patients: incidence and risk factor analysis. The Thoracic and Cardiovascular Surgeon, 55(1), 32-8.
Nisanoglu V, et al. Atrial Fibrillation After Coronary Artery Bypass Grafting in Elderly Patients: Incidence and Risk Factor Analysis. Thorac Cardiovasc Surg. 2007;55(1):32-8. PubMed PMID: 17285471.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atrial fibrillation after coronary artery bypass grafting in elderly patients: incidence and risk factor analysis. AU - Nisanoglu,V, AU - Erdil,N, AU - Aldemir,M, AU - Ozgur,B, AU - Berat Cihan,H, AU - Yologlu,S, AU - Battaloglu,B, PY - 2007/2/8/pubmed PY - 2007/4/4/medline PY - 2007/2/8/entrez SP - 32 EP - 8 JF - The Thoracic and cardiovascular surgeon JO - Thorac Cardiovasc Surg VL - 55 IS - 1 N2 - 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 % CI, 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. SN - 0171-6425 UR - https://www.unboundmedicine.com/medline/citation/17285471/Atrial_fibrillation_after_coronary_artery_bypass_grafting_in_elderly_patients:_incidence_and_risk_factor_analysis_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2006-924711 DB - PRIME DP - Unbound Medicine ER -