SYNTAX score predicts postoperative atrial fibrillation in patients undergoing on-pump isolated coronary artery bypass grafting surgery

Abstract

Objective:Atrial fibrillation (AF) is the most common arrhythmia following coronary artery by-pass graft surgery (CABG). The value of SYNTAX score to predict postoperative atrial fibrillation (PoAF) has not been clearly addressed. We aimed to evaluate this relationship in patients undergoing isolated CABG.Methods:This study was designed as a single-center, non-randomized, observational, prospective study. Ninety-four patients undergoing isolated on-pump CABG, who had sinus rhythm and were older than 18 years, were enrolled. Demographic characteristics of the patients were recorded; SYNTAX score was calculated preoperatively for each patient. The univariate and multivariate logistic regression analysis were used to determine for predictors of PoAF.Results:The median SYNTAX score of the enrolled patients was 21, (56–5). PoAF was observed in 31 (33.3%) patients. Univariate logistic regression showed that age, chronic obstructive pulmonary disease (COPD), red blood cell distribution width (RDW), urea, initial troponin I, peak postoperative troponin I, interventricular septum, left atrial diameter, and SYNTAX score were significantly associated with the frequency of PoAF following CABG. An independent association was identified with age [b 0.088, p:0.023, OR: 1.092, 95% CI (1.012–1.179)], COPD [(b: 2.222, p:0.003, OR: 9.228, 95% CI (2.150–39.602)], and SYNTAX score [(b: 0.130, p:0.002, OR: 1.139, 95% CI (1.050–1.235)].Conclusion:This study showed that a higher SYNTAX score was related to more frequent PoAF in patients undergoing isolated on-pump CABG.

Effect of Plasma Level of Vitamin D on Postoperative Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Grafting

“…Cerit et al [14] found that age was significantly associated with development of PoAF following CABG in univariate logistic regression analysis. In another study, Geçmen et al [15] showed that age was as an independent variable predicting the development of PoAF in both univariate and multivariate logistic regression analyses. It was found in two different studies that search the relationship between vitamin D and AF in patients undergoing CABG that age was not significantly associated with development of PoAF following CABG [16,17] .…”

Validation of SYNTAX and clinical SYNTAX scores in predicting atrial fibrillation following on-pump coronary artery bypass grafting

“…[32] Mendes et al [33] reported that angiographic evidence of right coronary artery stenosis was a predictor of PoAF. Gecmen et al [34] also found that higher SYNTAX scores were related to more frequent PoAF in patients undergoing isolated on-pump CABG. Contrary to this finding, Fukui et al [35] found no significant difference between high and low SYNTAX score groups for the development of PoAF in patients undergoing off-pump CABG.…”

<p>Predictors of Postoperative Atrial Fibrillation After Abdominal Surgery and Insights from Other Surgery Types</p>

“…9,15 No attempts have been made to create a prediction model for POAF after abdominal surgery exclusively; one model has included patients undergoing abdominal surgery, 15 and several models have included patients undergoing cardiac surgery. [10][11][12] A prediction model for patients undergoing abdominal surgery should consider the following clinical data: age, gender, congestive heart failure, renal function (chronic renal disease), pulmonary function (chronic obstructive pulmonary disease) and surgical attributes (eg, emergency vs elective, laparotomy vs laparoscopy, duration of surgery and organ system). Furthermore, addition of paraclinical data of left atrial (LA) size, PR-interval and QRS-duration have improved earlier risk-prediction models and should be considered.…”

“…Furthermore, addition of paraclinical data of left atrial (LA) size, PR-interval and QRS-duration have improved earlier risk-prediction models and should be considered. [10][11][12] Blood Plasma Biomarkers Inflammation biomarkers were investigated in one abdominal surgical study and were not found to be associated with POAF. 16 In non-cardiac thoracic surgery, similar conclusions were reached regarding both CRP and IL-6.…”

“…8,9 Current risk-stratification models for POAF after nonabdominal surgery primarily rely on clinical data, ie, demography and comorbidities. 10,11 Addition of preoperative paraclinical information such as biomarkers in blood or urine, electrocardiograms (ECGs) or cardiac imaging might improve the predictive abilities. 12,13 A robust model able to predict POAF could improve clinical management of patients undergoing abdominal surgery.…”