[Epidemiology and new predictors of atrial fibrillation after coronary surgery].
OBJECTIVE
Postoperative atrial fibrillation (PAF) is a frequent complication of coronary artery bypass grafting (CABG). Our aims were to study its epidemiology and to identify predictors in everyday clinical practice, while taking into account statin use, extracorporeal circulation, and new biomarkers of inflammation and ventricular stress.


METHODS
The study included 102 consecutive patients (65 [9] years, 72% male) who were undergoing CABG. Blood samples were taken the day before surgery to determine baseline levels of C-reactive protein (CRP) and N-terminal probrain natriuretic peptide (NT-proBNP). Details of baseline clinical characteristics, preoperative treatment and surgery were recorded. The end-point was PAF at 30 days.


RESULTS
The incidence of PAF was 23% (n=23; 3.2 [2.9] days, range 1-15 days). Its appearance was associated with a longer stay in the intensive care unit (+ 1 day; P=.019), but not with an increased total hospital stay (P=.213). Among patients with PAF, 4.3% had an embolism and 8.6% remained in atrial fibrillation at discharge. Moreover, PAF was associated with a longer duration of ischemia (28.5 [22.3] vs 18.0 [27.9]; P=.045) and a lower statin pretreatment rate (39% vs 66%; P=.022). Multivariate analysis showed that the only factor associated with a higher risk of PAF was the absence of statin pretreatment (odds ratio = 4.31, 95% confidence interval 1.33-13.88; P=.015). There was no association between either extracorporeal circulation or the baseline CRP or NT-proBNP level and an increased risk of PAF.


CONCLUSIONS
In everyday clinical practice, PAF is a frequent complication. Statin pretreatment could have a protective effect against its appearance.
Arribas-Leal
José M
JM
Servicio de Cirugía Cardiovascular, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. arribasdelpeso@telepolis.com
Pascual-Figal
Domingo A
DA
Tornel-Osorio
Pedro L
PL
Gutiérrez-García
Francisco
F
García-Puente del Corral
Julio J
JJ
Ray-López
Víctor G
VG
Valdés-Chavarrí
Mariano
M
Arcas-Meca
Ramón
R
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors