title: Predictors of Atrial Fibrillation After Coronary Artery Bypass Grafting: A Bayesian Analysis.
abstract: BACKGROUND
  This study was conducted to identify preoperative predictors of postoperative atrial fibrillation (POAF) after isolated coronary artery bypass grafting (CABG) by using a Bayesian analysis that included information from prior studies.
  
  
  METHODS
  We performed a prospective observational study from October 2008 to December 2013 of 1,481 patients who underwent isolated CABG with cardiopulmonary bypass and had no history of AF. Bayesian analysis was used to study the preoperative risks factors for POAF.
  
  
  RESULTS
  The POAF incidence was 21%. Multivariate analysis identified the following independent predictors of POAF after CABG: high CHA2DS2-VASc (Congestive heart failure, Hypertension [blood pressure >140/90 mm Hg or treated hypertension on medication], Age ≥75 years, Diabetes mellitus, prior Stroke or transient ischemic attack or thromboembolism, vascular disease, Age 65 to 74 years, Sex category [female sex]) score (odds ratio [OR], 1.23; 95% credible interval [CI], 1.14 to 1.33 per 1-point increment, probability (Pr) [OR > 1] = 1), severe obesity with a body mass index of 35 kg/m2or higher (OR, 1.28; 95% CI, 1.12 to 1.45; Pr [OR > 1] = 1), preoperative β-blocker use (OR, 1.12; 95% CI, 1.06 to 1.20; Pr [OR > 1] = 1), preoperative antiplatelet therapy (OR, 1.75; 95% CI, 1.14 to 2.79, Pr [OR > 1] = 1), and renal insufficiency with a creatinine clearance of less than 60 mL/min (OR, 1.34; 95% CI, 1.03 to 1.74; Pr [OR > 1] = 1).
  
  
  CONCLUSIONS
  This prospective Bayesian analysis identified five independent preoperative predictors of POAF after isolated CABG with cardiopulmonary bypass: CHA2DS2-VASc score, severe obesity, preoperative β-blocker use, preoperative antiplatelet therapy, and renal failure. The main interest in the CHA2DS2-VASc score as a predictor of POAF is that it is a simple and widely used bedside tool. Patients with these independent predictors of POAF may constitute a target population to test preventive strategies, such as non-antiarrhythmic and antiarrhythmic drugs.
authors: Department of Cardiovascular Surgery, Method and Clinical Research Group, University Hospital of Strasbourg, Strasbourg, France.
authors: Stéphanie
authors: S
authors: Perrier
authors: Department of Public Health, Method and Clinical Research Group, University Hospital of Strasbourg, Strasbourg, France.
authors: Nicolas
authors: N
authors: Meyer
authors: Department of Cardiovascular Surgery, Method and Clinical Research Group, University Hospital of Strasbourg, Strasbourg, France.
authors: Tam
authors: T
authors: Hoang Minh
authors: Department of Cardiovascular Surgery, Method and Clinical Research Group, University Hospital of Strasbourg, Strasbourg, France.
authors: Tarek
authors: T
authors: Announe
authors: Department of Cardiovascular Surgery, Method and Clinical Research Group, University Hospital of Strasbourg, Strasbourg, France.
authors: Jonathan
authors: J
authors: Bentz
authors: Department of Cardiovascular Surgery, Method and Clinical Research Group, University Hospital of Strasbourg, Strasbourg, France.
authors: Philippe
authors: P
authors: Billaud
authors: Department of Cardiovascular Surgery, Method and Clinical Research Group, University Hospital of Strasbourg, Strasbourg, France.
authors: Arnaud
authors: A
authors: Mommerot
authors: Department of Cardiovascular Surgery, Method and Clinical Research Group, University Hospital of Strasbourg, Strasbourg, France.
authors: Jean-Philippe
authors: JP
authors: Mazzucotelli
authors: Department of Cardiovascular Surgery, Method and Clinical Research Group, University Hospital of Strasbourg, Strasbourg, France. Electronic address: michel.kindo@chru-strasbourg.fr.
authors: Michel
authors: M
authors: Kindo
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology*; D001499:Bayes Theorem; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors