title: Sleep apnea is associated with new-onset atrial fibrillation after coronary artery bypass grafting.
abstract: OBJECTIVE
  New-onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG) remains a prevalent problem. We investigated the relationship between sleep apnea and new-onset post-CABG AF during inhospital stay.
  
  
  METHODS
  We prospectively recruited 171 patients listed for an elective CABG for an overnight sleep study. Sleep apnea was defined as apnea-hypopnea index greater than or equal to 5.
  
  
  RESULTS
  Among the 160 patients who completed the study, those in the sleep apnea group (n=128; 80%) had larger left atrial diameter (40.4±5.4 vs 38.4±6.0 mm; P=.03) and left ventricular end-diastolic dimension (52.6±7.9 vs 49.2±6.8 mm; P=.03) than those in the non-sleep apnea group. The incidence of new-onset post-CABG AF was higher for the sleep apnea than non-sleep apnea groups (24.8% vs 9.7%; P=.07). There was 1 inhospital death and 2 patients with acute renal failure requiring dialysis after CABG in the sleep apnea group. None of the patients developed inhospital stroke. Multiple logistic regression analysis showed that sleep apnea was an independent predictor of post-CABG AF (odds ratio, 4.4; 95% confidence interval, 1.1-18.1; P=.04).
  
  
  CONCLUSIONS
  Sleep apnea is prevalent in patients undergoing CABG. It increases the susceptibility to new-onset AF after CABG, probably related to atrial and ventricular remodeling.
authors.affiliation: Department of Cardiology, National University Heart Centre Singapore, Singapore.
authors.forename: Liang-Ping
authors.initials: LP
authors.lastname: Zhao
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore, Singapore.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Kofidis
authors.affiliation: Department of Cardiology, National University Heart Centre Singapore, Singapore.
authors.forename: Toon-Wei
authors.initials: TW
authors.lastname: Lim
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore; Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Siew-Pang
authors.initials: SP
authors.lastname: Chan
authors.affiliation: Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.
authors.forename: Thun-How
authors.initials: TH
authors.lastname: Ong
authors.affiliation: Department of Cardiology, National University Heart Centre Singapore, Singapore.
authors.forename: Huay-Cheem
authors.initials: HC
authors.lastname: Tan
authors.affiliation: Department of Cardiology, National University Heart Centre Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: mdclchr@nus.edu.sg.
authors.forename: Chi-Hang
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000628:therapy*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004452:Echocardiography; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D006435:Renal Dialysis; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications*; D020257:Ventricular Remodeling
keywords: Sleep apnea; arrhythmia; cardiovascular; coronary; predictor; surgery