Predictors of Postoperative Atrial Fibrillation after Isolated On-Pump Coronary Artery Bypass Grafting in Patients ≥60 Years Old

Abstract

Background: Postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) is one of the most common complications that can contribute to an increased risk of mortality, particularly in older patients. The identification of predictors of POAF after CABG could impact patient care. This study aims to determine the risk factors of POAF in patients ≥60 years old who underwent isolated on-pump coronary artery bypass grafting (ONCAB) in order to provide a basis for the prevention and treatment of POAF after ONCAB. Methods: Between October 2011 and November 2015, a total of 304 patients ≥60 years old underwent isolated ONCAB in our department. The patients were divided into 2 groups, the AF group and the non-AF group, according to the occurrence of POAF. A retrospective analysis was performed on the general characteristics and perioperative data of the patients. Logistic regression analysis was used to identify the predictors of POAF after ONCAB in patients ≥60 years old. Results: The incidence of POAF after ONCAB in patients ≥60 years old was 23.36% (71/304). Statistically significant differences were observed in patients’ age, history of hypertension, left atrium diameter, European System for Cardiac Operative Risk Evaluation (EuroSCORE) I and II, and the highest level of serum creatinine after operation (all P < .05). Logistic regression analyses showed that a history of hypertension (OR = 2.575, CI 1.208-5.488, P = .014), left atrium diameter (OR = 1.105, CI 1.047-1.167, P = .000) and EuroSCORE I score (OR = 1.132, CI 1.001-1.279, P = .048) were independent risk factors for POAF after ONCAB in patients ≥60 years old. Conclusion: The occurrence of POAF after isolated ONCAB in patients ≥60 years old was affected by many risk factors; a history of hypertension, the left atrium diameter and the EuroSCORE I score were all predictors of POAF.