Postoperative hyperglycemia and atrial fibrillation after coronary artery bypass graft surgery.
BACKGROUND
Postoperative atrial fibrillation (AF) is a common complication following coronary artery bypass grafting (CABG). We investigated the risk factors for postoperative AF and analyzed the relationship between blood sugar concentration (BS) and AF after CABG.


RESULTS
A total of 199 consecutive patients who underwent isolated CABG were retrospectively examined and classified according to the presence (n=95) or absence (n=104) of postoperative AF. On univariate analysis mean postoperative BS (P<0.001), postoperative drainage volume (P<0.001), age (P=0.034), presence of diabetes mellitus (DM; P=0.004), and postoperative estimated glomerular filtration rate (P=0.032) were significant risk factors for postoperative AF. On multivariate analysis mean postoperative BS (OR, 1.041; 95% CI: 1.008-1.079; P<0.001), postoperative drainage volume (OR, 1.003; 95% CI: 1.001-1.006; P=0.001), and age (OR, 1.040; 95% CI: 1.002-1.083; P=0.041) were significant risk factors for postoperative AF. Postoperative AF often occurred in patients with high postoperative BS, irrespective of DM. The BS cut-off that predicted postoperative AF occurrence was 180 mg/dl. A strong positive correlation existed between the time of the maximum postoperative BS and AF onset time (ρ=0.746).


CONCLUSIONS
Mean postoperative BS and postoperative drainage volume are risk factors for AF after CABG. AF was strongly associated with maximum postoperative BS. Intensive glycemic control could reduce AF occurrence after CABG.
Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East, Tokyo; Department of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Japan. wataru0812_drt@ybb.ne.jp
Wataru
W
Tatsuishi
Hitoshi
H
Adachi
Makoto
M
Murata
Junichi
J
Tomono
Shuichi
S
Okonogi
Syuichi
S
Okada
Yutaka
Y
Hasegawa
Masahiko
M
Ezure
Tatsuo
T
Kaneko
Shigeru
S
Ohshima
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D001786:Blood Glucose / Q000032:analysis; D002317:Cardiovascular Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002544:Cerebral Infarction / Q000453:epidemiology; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors
D001786:Blood Glucose; D002317:Cardiovascular Agents