Ufuk Turan Kursat Korkmaz, Erhan Renan Ucaroglu

Aortic knob width as a novel predictor of postoperative atrial fibrillation following off-pump coronary artery bypass grafting

The aim of this study was to determine whether aortic knob width (AKW) was related to the development of postoperative atrial fibrillation (AF) in patients undergoing off-pump coronary artery bypass grafting (CABG). Between July 2017 and June 2019, a total of 453 patients undergoing isolated off-pump CABG were enrolled to this retrospective observational cohort study. The patients were divided into two groups; as AF group (n=102) and non-AF group (n=351). The groups were compared with regard to preoperative demographics and clinical characteristics, intraoperative data, and postoperative outcomes, and then a multivariate logistic regression analysis was performed in order to determine the independent predictors of postoperative AF. The incidence of postoperative AF in our study population was found as 22.5% (n=102/453). The median age and AKW, and the frequencies of hypertension and chronic renal dysfunction were significantly higher in patients in AF group than in non- AF group. Multivariate logistic regression analysis revealed that age and AKW were the independent predictors of postoperative AF. The analysis yielded that the risk of POAF development increased by 5.2% with each one-year increase in patient age [OR 1.0520 with 95% CI= (1.0214, 1.0835), p

PDF

___

1. Mariscalco G, Klersy C, Zanobini M, et al. Atrial fibrillation after isolated coronary surgery affects late survival. Circulation. 2008;118:1612-8.
2. Saxena A, Dinh DT, Smith JA, et al. Usefulness of postoperative atrial fibrillation as an independent predictor for worse early and late outcomes after isolated coronary artery bypass grafting (multicenter Australian study of 19,497 patients). Am J Cardiol. 2012;109:219-25.
3. Hernández-Leiva E, Alvarado P, Dennis RJ. Postoperative atrial fibrillation: evaluation of its economic impact on the costs of cardiac surgery. Braz J Cardiovasc Surg. 2019;34:179-86.
4. Mariscalco G, Engström KG, Ferrarese S, et al. Relationship between atrial histopathology and atrial fibrillation after coronary bypass surgery. J Thorac Cardiovasc Surg. 2006;131:1364–72.
5. Zaman AG, Archbold RA, Helft G, et al. Atrial fibrillation after coronary artery bypass surgery: a model for preoperative risk stratification. Circulation. 2000;101:1403–8.
6. Mathew JP, Fontes ML, Tudor IC, et al. A multicenter risk index for atrial fibrillation after cardiac surgery. JAMA. 2004;291:1720–9.
7. Yuksel A, Kan II, Yolgosteren A, et al. Are the early postoperative outcomes of coronary artery bypass grafting surgery in elderly women worse compared to men's? Braz J Cardiovasc Surg. 2017;32:191-6.
8. Jaimes MC, Torrado LAA, Reyes NFS, et al. Hypothyroidism is a risk factor for atrial fibrillation after coronary artery bypass graft. Braz J Cardiovasc Surg. 2017;32:475-80.
9. Ozsin KK, Sanri US, Toktas F, et al. Effect of plasma level of vitamin D on postoperative atrial fibrillation in patients undergoing isolated coronary artery bypass grafting. Braz J Cardiovasc Surg. 2018;33:217-23.
10. Velioglu Y, Yuksel A. Predictors of postoperative atrial fibrillation after beating-heart coronary artery bypass surgery: is cardiopulmonary bypass a risk factor? Acta Cardiol Sin. 2019;35:468-75.
11. Yuksel A, Yolgosteren A, Kan II, et al. A comparison of early clinical outcomes of off-pump and on-pump coronary artery bypass grafting surgery in elderly patients. Acta Chir Belg. 2018;118:99-104.
12. Yun KH, Jeong MH, Oh SK, et al. Clinical significance of aortic knob width and calcification in unstable angina. Circ J. 2006;70:1280-3.
13. Higaki T, Kurisu S, Watanabe N, et al. Usefulness of aortic knob width on chest radiography to predict central hemodynamics in patients with known or suspected coronary artery disease. Clin Exp Hypertens. 2015;37:440-4.
14. Tomita Y, Kasai T, Ishiwata S, et al. Aortic knob width as a novel indicator of atherosclerosis and obstructive sleep apnea. J Atheroscler Thromb. 2020 1;27:501-8.
15. López-Ratón M, Rodríguez-Alvarez MX, Cadarso-Suárez C, et al. OptimalCutpoints: An R package for selecting optimal cutpoints in diagnostic tests. Journal of Statistical Software 2014;61:1-36.
16. R Core Team, 2014. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. http:// www.R-project.org/
17. Schotten U, Verheule S, irchhof P, et al. Pathophysiological mechanisms of atrial fibrillation: a translational appraisal. Physiol Rev. 2011;91:265- 325.
18. Polat A, Sahin I, Yucel C, et al. Coronary vasculature and postoperative atrial fibrillation: a risk factor analysis. Turk Gogus Kalp Dama. 2013;21:567-73.
19. Bohatch Júnior MS, Matkovski PD, Di Giovanni FJ, et al. Incidence of postoperative atrial fibrillation in patients undergoing on-pump and off-pump coronary artery bypass grafting. Rev Bras Cir Cardiovasc. 2015;30:316-24.
20. Yuksel A, Velioglu Y, Tecimer ME, et al. Is there any relationship of postoperative atrial fibrillation with the use of blood products and postoperative hemoglobin levels in patients undergoing coronary artery bypass grafting? Med-Science. 2019;8:16-20.
21. Yanartas M, Demir H, Hancer H, et al. Evaluation of risk factors for atrial fibrillation occurring after coronary bypass surgery. Kosuyolu Heart J. 2015;18:76-9.
22. Gaudino M, Andreotti F, Zamparelli R, et al. The -174G/C interleukin-6 polymorphism influences postoperative interleukin-6 levels and postoperative atrial fibrillation. Is atrial fibrillation an inflammatory complication? Circulation. 2003;108 Suppl 1:II195-9.
23. Erdil N, Gedik E, Donmez K, et al. Predictors of postoperative atrial fibrillation after on-pump coronary artery bypass grafting: is duration of mechanical ventilation time a risk factor? Ann Thorac Cardiovasc Surg. 2014;20:135-42.
24. Kitzman DW, Edwards WD. Age-related changes in the anatomy of the normal human heart. J Gerontol. 1990;45:M33-9.
25. Sawabe M, Hamamatsu A, Chida K, et al. Age is a major pathobiological determinant of aortic dilatation: a large autopsy study of community deaths. J Atheroscler Thromb. 2011;18:157-65.
26. Erkan H, Korkmaz L, Agaç MT, et al. Relation between carotid intima-media thickness and aortic knob width in patients with essential hypertension. Blood Press Monit. 2011;16:282-4.
27. Erdem K, Ozturk S, Ayhan S, et al. Predictive value of aortic knob width for postoperative atrial fibrillation in coronary artery bypass surgery. Anatol