[Risk factors for postoperative atrial fibrillation after coronary artery bypass grafting. A prospective analysis].
BACKGROUND
Atrial fibrillation (AF) is a relevant complication after coronary artery bypass grafting (CABG). However there is controversy regarding possible contributing factors.


OBJECTIVE
To study the incidence of AF, its risk factors and its repercussion on hospital stay and charges, in patients undergoing CABG.


METHODS
We prospectively collected information from all patients undergoing CABG in our institution, including demographic, surgical and laboratory variables. Exclusion criteria were chronic AF, recent onset AF and patients who needed additional surgical procedures. The primary endpoint was the incidence of AF during the hospital stay. Secondary endpoints were hospital length of stay and hospital charges.


RESULTS
We included 250 patients aged 62+/-9 years (199 males) in the analysis. Incidence of AF was 22% (54 patients). Multivariable analysis showed that age (Odds Ratio (OR) =1.10), previous CABG (OR =9.39), previous use of ACE inhibitors (OR =3.28) and aortic clamp >57 minutes (OR =3.97) were significantly associated with an increased risk of postoperative AF. Previous use of beta-blockers was associated with risk reduction (OR =0.43). Patients who developed AF had a longer hospital stay (p <0.001) and higher hospital charges (p =0.003).


CONCLUSIONS
AF is a frequent complication in patients undergoing CABG. Risk factors are age, time of aortic clamp, previous CABG and ACE inhibitors. Beta-blockers may prevent its occurrence. Furthermore, AF has a negative impact on both hospital stay and hospital charges.
Baeza V
Ricardo
R
Departamento de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile, Chile. rbaeza@puc.cl
Garayar P
Bernardita
B
Moran V
Sergio
S
Zalaquett S
Ricardo
R
Irarrázaval Ll
Manuel J
MJ
Becker R
Pedro
P
Viviani G
Paola
P
Ferrada K
Marcela
M
Corbalán H
Ramón
R
D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period