Development and Validation of a Nomogram for Post-operative Atrial Fibrillation in Off-Pump Coronary Artery Bypass Grafting

Abstract

Abstract Background The nomogram of post-operative atrial fibrillation (POAF) in off-pump coronary artery bypass grafting (OPCAB) was not established. We analyzed the incidence and individualized risk factors of POAF in participants following OPCAB and developed a prognostic nomogram for clinical practice. Methods Participants (n = 456) were randomly divided into training cohort (70%, n = 319) and validation cohort (30%, n = 137), and univariate and multivariate logistic regression were used to analyze the independent risk factors. In addition, we plotted DCA and CIC curves to compared with C2HEST, C2HEST, CHADS2 and CHADS2-VASc models and evaluated the clinical usefulness. Results Multivariable logistic regression analysis revealed that age, diabetes, hypertension, previous PCI, and intraoperative potassium were associated with POAF. Additionally, we developed nomogram with these predictors. Calibration curves calculated C-index in both training and validation cohort (0.809 and 0.886, respectively). DCA and CIC curves supported that the nomogram was superior to C2HEST, C2HEST, CHADS2 and CHADS2-VASc models and had effective clinical practice. Conclusions Age, diabetes, hypertension, previous PCI, and intraoperative potassium were associated with POAF. A nomogram was developed and validated to predict POAF in patients following OPCAB and provide accurate and individualized predictions.