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?

The goal of this study was to assess the relationship of postoperative atrial fibrillation (AF) with the use of blood products and postoperative hemoglobin levels following coronary artery bypass grafting (CABG). Eighty patients undergoing isolated CABG from June 2013 to December 2013 in our institution were included in this study, and divided into two groups that contain 40 patients according to their postoperative blood hemoglobin levels in this prospective study. In Group 1 and 2, there were patients that whose postoperative hemoglobin levels were below 10 g/dL and above 10 g/dL, respectively. Groups were compared with each other according to the use of blood products and occurrence of AF, then the relationship between use of blood products and occurrence of AF was analyzed. Moreover, patients that occur postoperative AF and patients that do not occur postoperative AF were compared with each other; thus, risk factor analysis for postoperative AF were performed. Postoperative AF was observed in 12 (30%) patients in Group 1 (mean age: 62.0±9.6 years, 24 male) and 7 (17.5%) in Group 2 (mean age: 60.3±9.0 years, 27 male), but this difference was not found to be statistically significant. When patients that occurred AF and did not occur AF were compared, according to the number of patients that had received blood products, the patients that had occurred AF had received more blood products than the patients whom had not occurred AF although again this difference was not statistically significant. In risk factor analysis; advanced age, low ejection fraction, obesity and the non-use of preoperative beta blocker were found to be risk factors associated with postoperative AF. In accordance with this study, the use of blood products and postoperative hemoglobin levels do not have an important impact on AF that occurs in patients undergoing isolated CABG. However, further studies with larger patient series are needed to elucidate this relationship.

___

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.

Polat A, Şahin İ, Yücel C, et al. Coronary vasculature and postoperative atrial fibrillation: a risk factor analysis. Turk Gogus Kalp Dama. 2013;21:567-73.

Mariscalco G, Klersy C, Zanobini M, et al. Atrial fibrillation after isolated coronary surgery affects late survival. Circulation. 2008;118:1612-8.

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.

Erdil N, Kaynak M, Dönmez K, et al. Nebivolol in preventing atrial fibrillation following coronary surgery in patients over 60 years of age. Rev Bras Cir Cardiovasc. 2014;29:581-7.

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.

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.

Koch CG, Li L, Van Wagoner DR, et al. Red cell transfusion is associated with an increased risk for postoperative atrial fibrillation. Ann Thorac Surg. 2006;82:1747-56.

Gerber DR. Risks of packed red blood cell transfusion in patients undergoing cardiac surgery. J Crit Care. 2012;27:1-9.

Sood N, Coleman CI, Kluger J, et al. The association among blood transfusions, white blood cell count, and the frequency of post-cardiothoracic surgery atrial fibrillation: a nested cohort study from the Atrial Fibrillation Suppression Trials I, II, and III. J Cardiothorac Vasc Anesth. 2009;23:22-7.

Choi YS, Shim JK, Hong SW, et al. Risk factors of atrial fibrillation following off-pump coronary artery bypass graft surgery: predictive value of C-reactive protein and transfusion requirement. Eur J Cardiothorac Surg. 2009;36:838-43.

Murphy GJ, Reeves BC, Rogers CA, et al. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation. 2007;116:2544-52.

Auer J, Weber T, Berent R, et al. Risk factors of postoperative atrial fibrillation after cardiac surgery. J Card Surg. 2005;20:425-31.

Khan MF, Wendel CS, Movahed MR. Prevention of post-coronary artery bypass grafting (CABG) atrial fibrillation: efficacy of prophylactic betablockers in the modern era: a meta-analysis of latest randomized controlled trials. Ann Noninvasive Electrocardiol. 2013;18:58-68.

Dunning J, Treasure T, Versteegh M, et al; EACTS Audit and Guidelines Committee. Guidelines on the prevention and management of de novo atrial fibrillation after cardiac and thoracic surgery. Eur J Cardiothorac Surg. 2006;30:852-872.

Filardo G, Hamilton C, Hebeler RF Jr, et al. New-onset postoperative atrial fibrillation after isolated coronary artery bypass graft surgery and long-term survival. Circ Cardiovasc Qual Outcomes. 2009;2:164-9.

Onk OA, Erkut B. Is the preoperative administration of amiodarone or metoprolol more effective in reducing atrial fibrillation: After coronary bypass surgery? Medicine (Baltimore). 2015;94:e1576.

Frustaci A, Chimenti C, Bellocci F, et al. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation. 1997;96:1180-4.

Buxbaum J, Furgerson W. Atrial fibrillation in severe anemia. JAMA. 1970;212:1958-9.

Hogue CW Jr, Creswell LL, Gutterman DD, et al. American College of Chest Physicians. Epidemiology, mechanisms, and risks: American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128:9S-16S.

Chelazzi C, Villa G, De Gaudio AR. Postoperative atrial fibrillation. ISRN Cardiol. 2011;2011:203179.

Ascione R, Caputo M, Calori G, et al. Predictors of atrial fibrillation after conventional and beating heart coronary surgery: A prospective, randomized study. Circulation. 2000;102:1530-5.

Straus S, Kacila M, Omerbasic E, et al. Atrial fibrillation and coronary bypass surgery - what can be risk factors for its’ appearance? Bosn J Basic Med Sci. 2010;10:78-82.

Topal AE, Eren MN. Predictors of atrial fibrillation occurrence after coronary artery bypass graft surgery. Gen Thorac Cardiovasc Surg. 2011;59:254-60.

Tinica G, Mocanu V, Zugun-Eloae F, et al. Clinical and histological predictive risk factors of atrial fibrillation in patients undergoing open-heart surgery. Exp Ther Med. 2015;10:2299-304.

Erdem K, Yazıcı M, Öztürk S, et al. Usefulness of CHA2DS2-VASc scoring system in predicting atrial fibrillation after coronary artery bypass grafting. Turk Gogus Kalp Dama. 2016;24:27-33.

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.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
Sayıdaki Diğer Makaleler

Parenteral systemic antifungal drugs and their clinical drug informations

İREM BOZBEY, Zeynep Ülkü GÜN, ARZU KARAKURT

Synthesis and the effect of a novel benzoxazole compound on breast cancer cell line

FUNDA KOSOVA, Özlem TEMİZ ARPACI, ERCÜMENT ÖLMEZ, MEHMET İBRAHİM TUĞLU

Investigation of the relationship between pain threshold and joint position sense in the cervical region

Ceyhun TÜRKMEN, Nezire KÖSE, Hatice ÇETİN, Esra DÜLGER, Sevil BİLGİN

Epidemiology of Blastocystis spp. in primary school students at a central village of Ordu province

Ülkü KARAMAN, Zeynep KOLÖREN, Emine AYAZ, Ümit GÜR

Amiodarone induced thyrotoxicosis may not respond to therapeutic plasma exchange like patients with graves’ disease: A report of two cases and literature review

İsmail YILDIZ, GÜLŞAH ELBÜKEN, Tugay ATASEVER, SİBEL ÖZKAN GÜRDAL, SAYİD SHAFİ ZUHUR

The evaluation of two different surgical approaches in total hip arthroplasty according to the patient satisfaction, plantar pressure distribution and trendelenburg sign

Ahmet YILDIRIM, Tacettin AYANAOĞLU, MUSTAFA ÖZER, Erdinç ESEN, Ulunay KANATLI, Selçuk BÖLÜKBAŞI

Comparison of patient specific quality assurance tests done with using different dosimetric systems for intensity modulated radiotherapy treatment plans

Kamil Erkan ÖZGEN, Şükran ESKİCİ ÖZTEP, Mehmet Bahadır ÇELİK, Eda Bengi YILMAZ, Mehmet KABADAYI

The better choice for measuring the gonial angle of different skeletal malocclusion types: Orthopantomograms or lateral cephalograms?

Tuğba HALİLOĞLU ÖZKAN, SELİM ARICI, ENES ÖZKAN

Prevalence of frailty syndrome and related factors in older adults living in a nursing home

Şemsinnur GÖÇER, OSMAN GÜNAY

Anesthesia management in kidney transplantation patients: Retrospective evaluation

MUKADDER ŞANLI, MUHARREM UÇAR