139 301

Cited 30 times in

Risk factors of atrial fibrillation following off-pump coronary artery bypass graft surgery: predictive value of C-reactive protein and transfusion requirement.

Authors
Choi, YS; Shim, JK; Hong, SW; Kim, DH; Kim, JC; Kwak, YL
Citation
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 36(5):838-843, 2009
Journal Title
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
ISSN
1010-79401873-734X
Abstract
OBJECTIVES: Considering the role of inflammatory reaction on the pathogenesis of atrial fibrillation (AF), the aim of this study is to investigate perioperative risk factors of AF, as well as to validate the predictive value of high-sensitive C-reactive protein (hsCRP), and transfusion requirement following off-pump coronary bypass surgery (OPCAB) in a prospective and observational trial. METHODS: In this cohort, 315 consecutive patients with normal sinus rhythm (NSR) undergoing elective isolated OPCAB are prospectively studied. The patients were classified as either NSR or AF group according to their postoperative rhythm, which was continuously monitored for the first 6 postoperative days. RESULTS: AF developed in 66 patients (19%). Univariate analysis demonstrated old age, pre-existing chronic renal failure, low left ventricle ejection fraction (LVEF <30%), highest hsCRP before the onset of AF, vasopressor and inotropic therapy, packed red blood cells (pRBCs) transfusion and amount of chest tube drainage as predictors of postoperative AF. In a stepwise multivariate analysis of these risk factors, low LVEF (odds ratio: 2.88; 95% confidence interval: 1.07-7.75; p=0.037), highest hsCRP before the onset of AF (odds ratio: 1.06; 95% confidence interval: 1.01-1.11; p=0.018), vasopressor therapy (odds ratio: 1.93; 95% confidence interval: 1.04-3.57; p=0.038) and pRBC transfusion (odds ratio: 5.32; 95% confidence interval: 2.80-10.11; p<0.001) remained as independent predictors of postoperative AF. CONCLUSIONS: Prophylactic strategies aimed at AF reduction may also be considered especially in patients with increased transfusion requirement, which showed highest predictive value for postoperative AF.
MeSH terms
AgedAtrial Fibrillation/etiology*Atrial Fibrillation/physiopathologyBiological Markers/bloodC-Reactive Protein/analysis*Coronary Artery Bypass, Off-Pump/adverse effects*Erythrocyte Transfusion*FemaleHumansInflammation Mediators/bloodMaleMiddle AgedPostoperative Care/methodsPrognosisProspective StudiesRisk FactorsStroke Volume
DOI
10.1016/j.ejcts.2009.05.003
PMID
19592264
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Anesthesiology & Pain Medicine
AJOU Authors
김대희
Full Text Link
Files in This Item:
Full-Text Not Available.txtDownload
Export
RIS (EndNote)
XLS (Excel)
XML

qrcode

해당 아이템을 이메일로 공유하기 원하시면 인증을 거치시기 바랍니다.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse