Affiliation:
1. Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University
2. Department of Public Health, Peking University
3. Department of Cardiovascular Surgery, Fujian Medical University Union Hospital
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.
Publisher
Research Square Platform LLC
Reference30 articles.
1. New-Onset Atrial Fibrillation After Cardiac Surgery: Pathophysiology, Prophylaxis, and Treatment;Lomivorotov VV;J Cardiothorac Vasc Anesth,2016
2. Clinical significance and risk factors for new onset and recurring atrial fibrillation following cardiac surgery - a retrospective data analysis;Todorov H;BMC Anesthesiol,2017
3. Atrial fibrillation following off-pump versus on-pump coronary artery bypass grafting: Incidence and risk factors;Lewicki L;Cardiol J,2016
4. White book of Chinese cardiovascular surgery and extracorporeal circulation in 2019;Circulation CSoE;Chin Soc Extracorpor Circulation,2020
5. Cost-effectiveness of on-pump and off-pump coronary artery bypass grafting for patients with coronary artery disease: Results from the MASS III trial;Scudeler TL;Int J Cardiol,2018