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Association of body mass index with new-onset atrial fibrillation after coronary artery bypass grafting operations.
Ann Thorac Surg. 2011 Jun; 91(6):1852-8.AT

Abstract

BACKGROUND

Postoperative atrial fibrillation (AF) frequently complicates coronary artery bypass grafting (CABG) operations. As the frequency of obesity has increased in the United States, the number of obese patients undergoing CABG has kept pace. This study sought to define the association between body mass index (BMI) and postoperative AF.

METHODS

We studied 12,367 consecutive patients with no history of AF who underwent isolated CABG operations. BMI was stratified according to Centers for Disease Control and Prevention criteria, and differences in baseline clinical and operative characteristics were adjusted through multivariate logistic regression models.

RESULTS

The unadjusted incidence of new-onset postoperative AF demonstrated a U-shape with regard to BMI. The highest incidence (34%) was found in the "lean" stratum (BMI<18.5 kg/m2), followed by 32% in the "severely obese" (BMI≥40 kg/m2) stratum. Lower incidences were found in the "normal" stratum (30%), in the "obese" stratum (28%), and the lowest incidence (26%) was in the overweight stratum. Observed incidence was 50% greater than the expected incidence in the "severely obese" stratum (32% vs 21%). In multivariate regression analysis adjusted for age and other covariates, BMI remains a strong risk factor for new-onset postoperative AF. Compared with normal BMI, obesity (odds ratio, 1.24; 95% confidence interval, 1.08 to 1.42) and severe obesity (odds ratio, 2.00; 95% confidence interval, 1.54 to 2.57) both emerged as strong risk factors for postoperative AF. No association was found between a lean BMI and postoperative AF (odds ratio, 1.14; 95% confidence interval, 0.66 to 1.98).

CONCLUSIONS

After adjusting for potential confounders, obesity, as reflected by the body mass index, remains an independent predictor of postoperative AF.

Authors+Show Affiliations

Department of Surgery, Section of Cardiac Surgery, Washington Hospital Center, Washington, DC 20010-2975, USA. xiumei.sun@medstar.netNo 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

21619982

Citation

Sun, Xiumei, et al. "Association of Body Mass Index With New-onset Atrial Fibrillation After Coronary Artery Bypass Grafting Operations." The Annals of Thoracic Surgery, vol. 91, no. 6, 2011, pp. 1852-8.
Sun X, Boyce SW, Hill PC, et al. Association of body mass index with new-onset atrial fibrillation after coronary artery bypass grafting operations. Ann Thorac Surg. 2011;91(6):1852-8.
Sun, X., Boyce, S. W., Hill, P. C., Bafi, A. S., Xue, Z., Lindsay, J., & Corso, P. J. (2011). Association of body mass index with new-onset atrial fibrillation after coronary artery bypass grafting operations. The Annals of Thoracic Surgery, 91(6), 1852-8. https://doi.org/10.1016/j.athoracsur.2011.03.022
Sun X, et al. Association of Body Mass Index With New-onset Atrial Fibrillation After Coronary Artery Bypass Grafting Operations. Ann Thorac Surg. 2011;91(6):1852-8. PubMed PMID: 21619982.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of body mass index with new-onset atrial fibrillation after coronary artery bypass grafting operations. AU - Sun,Xiumei, AU - Boyce,Steven W, AU - Hill,Peter C, AU - Bafi,Ammar S, AU - Xue,Zhengyi, AU - Lindsay,Joseph, AU - Corso,Paul J, PY - 2011/01/03/received PY - 2011/03/08/revised PY - 2011/03/09/accepted PY - 2011/5/31/entrez PY - 2011/5/31/pubmed PY - 2011/8/13/medline SP - 1852 EP - 8 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 91 IS - 6 N2 - BACKGROUND: Postoperative atrial fibrillation (AF) frequently complicates coronary artery bypass grafting (CABG) operations. As the frequency of obesity has increased in the United States, the number of obese patients undergoing CABG has kept pace. This study sought to define the association between body mass index (BMI) and postoperative AF. METHODS: We studied 12,367 consecutive patients with no history of AF who underwent isolated CABG operations. BMI was stratified according to Centers for Disease Control and Prevention criteria, and differences in baseline clinical and operative characteristics were adjusted through multivariate logistic regression models. RESULTS: The unadjusted incidence of new-onset postoperative AF demonstrated a U-shape with regard to BMI. The highest incidence (34%) was found in the "lean" stratum (BMI<18.5 kg/m2), followed by 32% in the "severely obese" (BMI≥40 kg/m2) stratum. Lower incidences were found in the "normal" stratum (30%), in the "obese" stratum (28%), and the lowest incidence (26%) was in the overweight stratum. Observed incidence was 50% greater than the expected incidence in the "severely obese" stratum (32% vs 21%). In multivariate regression analysis adjusted for age and other covariates, BMI remains a strong risk factor for new-onset postoperative AF. Compared with normal BMI, obesity (odds ratio, 1.24; 95% confidence interval, 1.08 to 1.42) and severe obesity (odds ratio, 2.00; 95% confidence interval, 1.54 to 2.57) both emerged as strong risk factors for postoperative AF. No association was found between a lean BMI and postoperative AF (odds ratio, 1.14; 95% confidence interval, 0.66 to 1.98). CONCLUSIONS: After adjusting for potential confounders, obesity, as reflected by the body mass index, remains an independent predictor of postoperative AF. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/21619982/Association_of_body_mass_index_with_new_onset_atrial_fibrillation_after_coronary_artery_bypass_grafting_operations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(11)00620-5 DB - PRIME DP - Unbound Medicine ER -