Khan Muhammad F, Herle Aravind, Reza Movahed Mohammad
Southern Arizona VA Medical Center ,University of Arizona.
Mercy Hospital of Buffalo NY.
J Atr Fibrillation. 2013 Feb 12;5(5):800. doi: 10.4022/jafib.800. eCollection 2013 Feb-Mar.
Atrial fibrillation/flutter (AF) is the most common arrhythmia following coronary artery bypass grafting (CABG) and it increases morbidity and mortality associated with this procedure. The purpose of this study was to evaluate the predictability of this arrhythmia using previously identified risk factors and to assess the efficacy of recommended prophylactic beta blocker (BB) therapy in the prevention of post CABG AF. We performed a retrospective chart analysis of consecutive patients undergoing elective CABG during 1 year period. Patients who developed new onset AF after the surgery were designated as cases and those who did not, as controls. 41 different variables were analyzed using Chi-square test and independent sample t-test. Multivariate analysis was carried out using logistic regression model. 23% patients undergoing CABG developed AF during post-operative period. Statistically significant differences were observed between the two groups in terms of age, use of peri-operative Aspirin (ASA), current smoking, previous history of AF, left atrial size, history of congestive heart failure (CHF) and brain natriuretic peptide (BNP) levels. In terms of prophylactic therapy, preoperative BB did not independently protect against post CABG AF. On multivariate analysis, only age, use of ASA and previous history of AF remained as independent predictors of post CABG AF. In our study population, the use of preoperative BB did not independently decrease the risk of post-CABGAF. Age, peri-operative ASA use and previous history of AF remained strong independent predictors of post- operative AF.
心房颤动/扑动（AF）是冠状动脉旁路移植术（CABG）后最常见的心律失常，它会增加与该手术相关的发病率和死亡率。本研究的目的是使用先前确定的危险因素评估这种心律失常的可预测性，并评估推荐的预防性β受体阻滞剂（BB）治疗在预防CABG术后AF方面的疗效。我们对连续1年接受择期CABG的患者进行了回顾性病历分析。术后出现新发AF的患者被指定为病例组，未出现的患者为对照组。使用卡方检验和独立样本t检验分析了41个不同变量。使用逻辑回归模型进行多变量分析。23%接受CABG的患者在术后出现AF。两组在年龄、围手术期阿司匹林（ASA）的使用、当前吸烟情况、既往AF病史、左心房大小、充血性心力衰竭（CHF）病史和脑钠肽（BNP）水平方面存在统计学显著差异。在预防性治疗方面，术前使用BB并不能独立预防CABG术后AF。多变量分析显示，只有年龄、ASA的使用和既往AF病史仍然是CABG术后AF的独立预测因素。在我们的研究人群中，术前使用BB并不能独立降低CABG术后AF的风险。年龄、围手术期ASA的使用和既往AF病史仍然是术后AF的强有力独立预测因素。
