Epidemiología y nuevos predictores de la fibrilación auricular tras cirugía coronaria

Arribas-Leal, José María; Pascual-Figal, Domingo A.; Tornel-Osorio, Pedro L.; Gutiérrez-García, Francisco; Corral, Julio J. García-Puente del; Ray-López, Víctor G.; Valdés‐Chávarri, Mariano; Arcas-Meca, Ramón

doi:10.1157/13108998

Cited by 16 publications

(5 citation statements)

References 28 publications

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“…Some studies found that male sex is an independent predictor of POAF development [9], but it seems that there are many more authors who do not agree with that [3,7,8,14]. In our study male sex was not found to be an independent variable in the occurrence of atrial fibrillation.…”

Section: Discussioncontrasting

confidence: 75%

“…Numerous studies have shown that hypertension increased the risk of POAF [1,4,12,15], but there are authors who disagree [7,16]. The results of our study showed that hypertension was an independent predictor, one of the most important, for the development of POAF in our population.…”

Section: Discussionsupporting

confidence: 50%

“…Older age is the only concurrent risk factor of all conducted studies [1,2,7–9,13,14]. Advanced age is associated with degenerative changes such as fibrosis and dilatation, which affect the atrial electrophysiological characteristics (shortness of effective refractory period, dispersion of refractoriness and conduction, abnormal automaticity), and represent a precondition for the development of POAF.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of many factors were estimated: age, sex, hypertension, diabetes, obesity, metabolic syndrome, renal failure, chronic obstructive pulmonary disease, left atrium size, left ventricular hypertrophy, markers of inflammation (leukocytosis, CRP, IL-6) and heart failure (BNP and pro-BNP), duration of the operation, number of grafts, or presence of significant left main stenosis. However, there is no agreement in the results of these investigations [7–9]. …”

Section: Introductionmentioning

confidence: 98%

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Predictors of atrial fibrillation following coronary artery bypass surgery

2011

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SummaryBackgroundNew-onset atrial fibrillation is the most common form of rhythm disturbance following coronary artery bypass grafting surgery (CABG). It is still unclear which factors have a significant impact on its occurrence after this procedure. The aim of this study was to evaluate clinical predictors of postoperative atrial fibrillation (POAF) after myocardial revascularization.Material/MethodsWe performed a retrospective analysis of 322 patients who underwent the first CABG operation without baseline atrial fibrillation. All subjects underwent laboratory blood tests, echocardiography and selective coronarography with ventriculography. Patients were continuously electrocardiographically monitored during the first 48–72h after the operation for the occurrence of POAF.ResultsPOAF was diagnosed in 72 (22.4%) of the patients. Multivariate logistic regression analysis was used to identify the following independent clinical predictors of POAF: age ≥65 years (OR 1.78; 95%CI: 1.06–2.76; p=0.043), hypertension (OR 1.97; 95%CI: 1.15–3.21; p=0.018), diabetes mellitus (OR 2.09; 95% CI: 1.31–5.33; p=0.010), obesity (OR 1.51; 95%CI: 1.03–3.87; p=0.031), hypercholesterolemia (OR 2.17, 95%CI: 1.05–4.25; p=0.027), leukocytosis (OR 2.32, 95%CI: 1.45–5.24; p=0.037), and left ventricular segmental kinetic disturbances (OR 3.01; 95%CI: 1.65–4.61, p<0.001).ConclusionsThis study demonstrates that advanced age, hypertension, diabetes, obesity, hypercholesterolemia, leukocytosis, and segmental kinetic disturbances of the left ventricle are powerful risk factors for the occurrence of POAF.

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Section: Discussioncontrasting

confidence: 75%

Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Predictors of atrial fibrillation following coronary artery bypass surgery

2011

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“…AF is associated with an increased morbidity and mortality after cardiac surgery and a longer hospital length of stay23. A significant association between fibrosis, inflammation, oxidative stress and the development, recurrence and perpetuation of AF has been hypothesized4.…”

mentioning

confidence: 99%

Galectin-3 as a marker of interstitial atrial remodelling involved in atrial fibrillation

Hernández-Romero

Vı́lchez

Lahoz

et al. 2017

Sci Rep

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Remodelling in the atria could appear as a result of hypertension, diabetes or ischaemic heart disease. Galectin-3 (Gal-3) is a mediator of profibrotic pathways and a potential biomarker of cardiac remodelling. We prospectively recruited consecutive patients undergoing elective cardiac surgery. Preoperative Gal-3 levels were determined from serum samples, and the presence of fibrosis was assessed from atrial appendage tissue samples obtained during cardiac surgery. We included 100 patients with aortic valve or ischaemic heart diseases and 15 controls with permanent AF. Gal-3 levels were associated with sex, left atrial volume, previous cardiac disease, diabetes mellitus, hypertension, NYHA and NT-proBNP. We observed differences in serum Gal-3 concentrations between patients and controls with permanent AF (p = 0.020). We performed ROC curves related to fibrosis and established a cutoff point for Gal-3 >13.65 ng/ml. Multivariate analyses showed previous cardiac disease, NYHA scale and high Gal-3 to be independent predictors of fibrosis. After adjustment for confounding factors, atrial fibrosis remained the only independent factor for the development of AF (p = 0.022). High Gal-3 serum levels predict fibrosis of the atrial appendage. NYHA scale and previous cardiac disease were also associated with tissue fibrosis in patients undergoing surgery. Atrial fibrosis was the only independent predictor for post-operative AF occurrence in our model after correcting for confounding factors.

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