Hypothyroidism is a Risk Factor for Atrial Fibrillation after Coronary Artery Bypass Graft

Jaimes, Marisol Carreño; Torrado, Luis Alberto Arciniegas; Reyes, Nestor Fernando Sandoval; Mackenzie, Jaime Camacho; Mallarino, Juan Pablo Umaña

doi:10.21470/1678-9741-2017-0080

Cited by 12 publications

(8 citation statements)

References 22 publications

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“…Our incidence of atrial brillation was approximate 20%, which was in agreement with previous reports [19,20]. Jaimes and his colleagues [21] reported that hypothyroidism was a risk factor for the onset of postoperative atrial brillation in patients undergoing CABG. But the exposed patients in their study included ones only with TSH elevation, and preoperative baseline characteristics were not evenly distributed among the two groups.…”

Section: Discussionsupporting

confidence: 93%

Impact of Overt Hypothyroidism on Early Outcomes of Coronary Artery Surgery

Zhang

Wang

Yuan

et al. 2020

Preprint

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Background: The association between preoperative overt hypothyroidism and early outcomes after coronary artery bypass grafting (CABG) is unclear. This study aimed to evaluate the influence of overt hypothyroidism on the outcomes of CABG. Methods: The series included 189 overt hypothyroid patients who underwent CABG at Fuwai Hospital. These patients were 1:4 matched with 737 euthyroid patients using propensity score matching. The early postoperative outcomes were compared. Results: After propensity score matching, the incidences of impaired wound healing, reintubation, and the total complications were higher in hypothyroid patients than euthyroid patients (11.8% vs. 0.9%, p<0.001; 2.1% vs. 0.4%, p=0.03; 39.6% vs. 30.3%, p=0.015, respectively). Multivariate analysis showed overt hypothyroidism was significantly associated with the occurrence of impaired wound healing (odds ratio [OR]=12.29, p<0.001), reintubation (OR=5.71, p=0.047), and the total complications (OR=1.31, p=0.049). The OR of the total complications was 1.43 (p=0.03) in hypothyroid patients with abnormal thyroid-stimulating hormone compared with euthyroid patients. The proportions of the use of dopamine, adrenaline, milrinone, and dobutamine in hypothyroid patients were higher than euthyroid patients (75.4% vs. 67.6%, p=0.038; 10.7% vs. 6.1%, p=0.028; 3.2% vs. 0.3%, p=0.001; 4.8% vs. 1.2%, p=0.004, respectively). The total duration of inotropic support and mechanical ventilation time in hypothyroid patients were longer than euthyroid patients (median duration: 4 days vs. 3 days, p=0.003; 17 hours vs. 15 hours, p<0.001, respectively). Conclusions: CABG in overt hypothyroid patients is associated with a higher incidence of postoperative complications, stronger postoperative inotropic support, and longer mechanical ventilation time.

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Section: Discussionsupporting

confidence: 93%

Impact of Overt Hypothyroidism on Early Outcomes of Coronary Artery Surgery

Zhang

Wang

Yuan

et al. 2020

Preprint

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“…Our incidence of atrial fibrillation was approximate 20%, which was in agreement with previous reports [Kosmidou 2018;Zheng 2016]. Jaimes and his colleagues [Jaimes 2017] reported that hypothyroidism was a risk factor for the onset of postoperative atrial fibrillation in patients undergoing CABG. But the exposed patients in their study included ones only with TSH elevation, and preoperative baseline characteristics were not evenly distributed among the two groups.…”

Section: E874supporting

confidence: 92%

Impact of Overt Hypothyroidism on Early Outcomes of Coronary Artery Surgery

Zhao

Feng

Zhao

et al. 2021

HSF

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Background: The association between preoperative overt hypothyroidism and early outcomes after coronary artery bypass grafting (CABG) is unclear. This study aimed to evaluate the influence of overt hypothyroidism on the outcomes of CABG. Methods: The series included 189 overt hypothyroid patients, who underwent CABG at Fuwai Hospital. These patients were 1:4 matched with 737 euthyroid patients using propensity score matching. The early postoperative outcomes were compared. Results: After propensity score matching, the incidences of impaired wound healing, reintubation, and the total complications were higher in hypothyroid patients than euthyroid patients (11.8% vs. 0.9%, P < 0.001; 2.1% vs. 0.4%, P = 0.03; 39.6% vs. 30.3%, P = 0.015, respectively). Multivariate analysis showed overt hypothyroidism was significantly associated with the occurrence of impaired wound healing (odds ratio [OR]=12.29, P < 0.001), reintubation (OR=5.71, P = 0.047), and the total complications (OR=1.31, P = 0.049). The OR of the total complications was 1.43 (P = 0.03) in hypothyroid patients with abnormal thyroid-stimulating hormone compared with euthyroid patients. The proportions of the use of dopamine, adrenaline, milrinone, and dobutamine in hypothyroid patients were higher than euthyroid patients (75.4% vs. 67.6%, P = 0.038; 10.7% vs. 6.1%, P = 0.028; 3.2% vs. 0.3%, P = 0.001; 4.8% vs. 1.2%, P = 0.004, respectively). The total duration of inotropic support and mechanical ventilation time in hypothyroid patients were longer than euthyroid patients (median duration: 4 days vs. 3 days, P = 0.003; 17 hours vs. 15 hours, P < 0.001, respectively). Conclusions: CABG in overt hypothyroid patients is associated with a higher incidence of postoperative complications, stronger postoperative inotropic support, and longer mechanical ventilation time.

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“…Worku et al 12 reported that both overt and SCH were associated with atrial fibrillation, but the sample size was small and only 52% of patients received a preoperative beta‐blocker. Jaimes et al 13 reported that hypothyroidism was a risk factor for the onset of postoperative atrial fibrillation while the preoperative baseline characteristics were not evenly distributed among the two groups.…”

Section: Discussionmentioning

confidence: 99%

Impact of subclinical hypothyroidism on outcomes of coronary bypass surgery

Zhao

Yuan

et al. 2021

J Card Surg

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Background Subclinical hypothyroidism (SCH) is characterized by an elevated thyroid‐stimulating hormone and normal free thyroxine. This study aimed to evaluate the influence of SCH on the recovery of patients after coronary artery bypass grafting (CABG). Methods From January 2015 to December 2018, 548 SCH patients and 6718 euthyroid patients who underwent CABG were identified. Propensity score matching was used to create two cohorts with similar baseline characteristics (n = 545 in each group). The early postoperative outcomes were compared. Results After CABG, there was no difference in the incidence of postoperative atrial fibrillation between the two groups (20.4% in the SCH group and 20.6% in the euthyroidism group; odds ratio: 0.99; 95% confidence interval: 0.74–1.33; p = 0.94). Subgroup analyses did not indicate an effect in any category of patients. The proportions of the use of dopamine and noradrenaline in the SCH group were higher than those in the euthyroid patients (76.7% vs. 68.6%, p = 0.003; 56.5% vs. 49.0%, p = 0.01, respectively). The total duration of inotropic support in the SCH group was longer than that in the euthyroid patients (median duration: 4 vs. 3 days, p = 0.002). The incidence of impaired wound healing was higher in the SCH group than in the euthyroid group (3.7% vs. 1.1%, p = 0.005). Conclusions Compared with euthyroidism, SCH is not associated with an increased risk of atrial fibrillation in patients undergoing CABG. It is associated with an increased risk of several minor perioperative problems, which should be anticipated and preemptively managed.

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Hypothyroidism is a Risk Factor for Atrial Fibrillation after Coronary Artery Bypass Graft

Cited by 12 publications

References 22 publications

Impact of Overt Hypothyroidism on Early Outcomes of Coronary Artery Surgery

Impact of Overt Hypothyroidism on Early Outcomes of Coronary Artery Surgery

Impact of Overt Hypothyroidism on Early Outcomes of Coronary Artery Surgery

Impact of subclinical hypothyroidism on outcomes of coronary bypass surgery

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