Gode Safa, Aksu Timuçin, Demirel Aylin, Sunbul Murat, Gul Mehmet, Bakır Ihsan, Yeniterzi Mehmet
Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey.
J Cardiovasc Thorac Res. 2016;8(4):140-146. doi: 10.15171/jcvtr.2016.29. Epub 2016 Dec 27.
Various factors may be responsible for the development of postoperative atrial fibrillation (POAF) in coronary artery bypass graft (CABG) patients. In our study, we demonstrated the effect of vitamin D deficiency on the development of POAF. In this prospective case control study, patients undergoing elective, isolated CABG were considered. A total of 15 patients (16.6%) who developed POAF during the first five days after surgery made up the POAF group. Seventy-five patients that had a sinus rhythm in the same period were the non-POAF group. The two groups were compared statistically in terms of laboratory, clinical, echocardiographic, operative, and postoperative parameters. All patients were in sinus rhythm at discharge. The baseline characteristics of the study groups were comparable. The POAF group had a lower vitamin D level than the non-POAF group (9.0 ± 5.0 and 15.0 ± 8.4 ng/mL, respectively; =0.007). In the POAF group, the patients' left atrium diameter and incidence of hypertension (HT) were higher than those of the non-POAF group. Incidence of POAF was significantly higher in patients with vitamin D deficiency or insufficiency than the patients with vitamin D level in normal range. Therefore vitamin D deficiency or insufficiency may be a predictor of POAF in patients with CABG.
多种因素可能导致冠状动脉旁路移植术(CABG)患者发生术后房颤(POAF)。在我们的研究中,我们证明了维生素D缺乏对POAF发生的影响。在这项前瞻性病例对照研究中,纳入了接受择期、单纯CABG的患者。共有15例患者(16.6%)在术后前五天发生POAF,组成POAF组。同期有窦性心律的75例患者为非POAF组。对两组患者的实验室、临床、超声心动图、手术及术后参数进行统计学比较。所有患者出院时均为窦性心律。研究组的基线特征具有可比性。POAF组的维生素D水平低于非POAF组(分别为9.0±5.0和15.0±8.4 ng/mL;P=0.007)。在POAF组,患者的左心房直径和高血压(HT)发生率高于非POAF组。维生素D缺乏或不足的患者中POAF的发生率显著高于维生素D水平在正常范围的患者。因此,维生素D缺乏或不足可能是CABG患者发生POAF的一个预测指标。