Visceral Adiposity Index and Prognostic Nutritional Index in Predicting Atrial Fibrillation after On-Pump Coronary Artery Bypass Operations: a Prospective Study

Abstract

Introduction Rhythm problems are the most observed complications following coronary artery bypass grafting (CABG), the most common being postoperative atrial fibrillation (PoAF), with an incidence reaching 50% of the patients. In this study, we aimed to investigate the predictive importance of prognostic nutritional index (PNI) and visceral adiposity index (VAI) in predicting PoAF, which occurs after CABG accompanied by cardiopulmonary bypass. Methods Patients who underwent isolated CABG with cardiopulmonary bypass between June 15 and October 15, 2019, were prospectively included in the study. Patients who did not develop in-hospital PoAF were identified as Group 1, and those who did constituted Group 2. Results PoAF developed in 55 (27.6%) patients (Group 2). The mean age of the 144 patients included in Group 1 and 55 patients in Group 2 were 56.9±8.7 and 64.3±10.2 years, respectively ( P <0.001). In multivariate analysis Model 1, age (odds ratio [OR]: 1.084, confidence interval [CI]: 1.010-1.176, P =0.009), chronic obstructive pulmonary disease (OR: 0.798, CI: 0.664-0.928, P =0.048), and PNI (OR: 1.052, CI: 1.015-1.379, P =0.011) were determined as independent predictors for PoAF. In Model 2, age (OR: 1.078, CI: 1.008-1.194, P =0.012), lymphocyte counts (OR: 0.412, CI: 0.374-0.778, P =0.032), and VAI (OR: 1.516, CI: 1.314-2.154, P <0.001) were determined as independent predictors for PoAF. Conclusion In this study, we determined that low PNI, a simply calculable and cheap parameter, along with high VAI were risk factors for PoAF.

Dose-response relationship among body mass index, abdominal adiposity and atrial fibrillation in patients undergoing cardiac surgery: a meta-analysis of 35 cohorts

“…(Fig. S3) In another cohort study, Engin et al (2020) showed that the visceral adiposity index significantly increased the risk of AF in patients who underwent isolated CABG.…”

“…Three studies (Engin et al, 2020;Girerd et al, 2009;Ivanovic et al, 2014) reported an analysis of the association between visceral adiposity and the risk of AF after CABG and included 536 cases among 2,691 participants. Due to the limited number of studies, we did not pool the results.…”

Predictive Value of HATCH Scoring and Waist-to-Height Ratio in Atrial Fibrillation Following Coronary Artery Bypass Operations Performed with Cardiopulmonary Bypass

“…It has been shown that high BMI values can increase PoAF rates [ 5 ]. However, some studies revealed that central obesity may be a better predictor for PoAF [ 6 , 7 ]. Accordingly, waist/height ratio (WHR) is an important indicator of central obesity and it can be a better predictor than BMI in terms of the development of cardiovascular disease and impaired glucose tolerance [ 8 , 9 ].…”

The importance of mean platelet volume to lymphocyte ratio in predicting atrial fibrillation after coronary bypass operations

“…These technological advances have also improved cardiopulmonary bypass (CPB) systems, and CABG operations can be performed with low mortality and morbidity rates. However, apart from mortality, morbid conditions such as renal failure, atrial fibrillation, and cerebrovascular accident may occur after these operations [2][3][4]. Postoperative atrial fibrillation (PoAF), one of these cases, can be seen at a rate of 25-40%.…”