University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovasculer Surgery, Yıldırım/Bursa, Turkey.
University of Health Sciences, Mehmet Akif İnan Training and Research Hospital, Department of Cardiovascular Surgery, Karaköprü/Şanlıurfa, Turkey.
Heart Surg Forum. 2021 Nov 30;24(6):E977-E982. doi: 10.1532/hsf.4279.
Postoperative atrial fibrillation (PoAF) is observed at a rate of 25-40% in the postoperative period after coronary artery bypass graft (CABG) surgery and can increase mortality, morbidity, and treatment costs. Inflammation and coronary artery disease (CAD) severity are important parameters to predict PoAF.
Patients with right coronary artery (RCA) disease who underwent isolated CABG operation between January 1, 2017 and April 15, 2020, were included in the study retrospectively. Demographic features, preoperative total Gensini score (TGS), right coronary Gensini score (RCGS), systemic immune inflammation index (SII), and postoperative characteristics were recorded.
A total of 283 patients were included in the study. Those who did not develop PoAF were included in Group 1 (N = 211, median age=60 (33-82) years), and those who did were included in Group 2 (N = 72, median age=68 (42-85) years). There were no statistically significant differences between the two groups, in terms of gender, hypercholesterolemia, cerebrovascular event/trans-ischemic attack history, body mass index, diabetes mellitus, smoking, beta blocker/angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use, ejection fraction and left atrium diameters. As a result of multivariate analysis, advanced age (OR: 2.816 CI 95%: 1.687-3.498 P < .001), hypertension (OR:0.896, CI 95%: 0.578-0.965, P = .022), SII (OR: 1.548 CI 95%: 1.265-2.896, P = .003), TGS (OR: 1.235, CI 95%: 1.096-2.424, P = .012), and RCGS (OR: 2.112, CI 95%: 1.665-4.156, P < .001) values were determined as independent predictors for predicting postoperative atrial fibrillation.
In this study, we showed that RCGS and SII values were independent predictors of PoAF after CABG operations in patients with right coronary artery disease.
冠状动脉旁路移植术（CABG）后，术后心房颤动（PoAF）的发生率为 25-40%，可增加死亡率、发病率和治疗费用。炎症和冠状动脉疾病（CAD）严重程度是预测 PoAF 的重要参数。
本研究回顾性纳入 2017 年 1 月 1 日至 2020 年 4 月 15 日期间行单纯 CABG 手术的右冠状动脉疾病（RCA）患者。记录患者的人口统计学特征、术前总 Gensini 评分（TGS）、右冠状动脉 Gensini 评分（RCGS）、全身免疫炎症指数（SII）和术后特征。
本研究共纳入 283 例患者。未发生 PoAF 的患者纳入第 1 组（N=211，中位年龄 60[33-82]岁），发生 PoAF 的患者纳入第 2 组（N=72，中位年龄 68[42-85]岁）。两组患者在性别、高胆固醇血症、脑血管意外/短暂性脑缺血发作史、体重指数、糖尿病、吸烟、β受体阻滞剂/血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂使用、射血分数和左心房直径方面无统计学差异。多变量分析结果显示，高龄（OR：2.816，95%CI：1.687-3.498，P<.001）、高血压（OR：0.896，95%CI：0.578-0.965，P=0.022）、SII（OR：1.548，95%CI：1.265-2.896，P=0.003）、TGS（OR：1.235，95%CI：1.096-2.424，P=0.012）和 RCGS（OR：2.112，95%CI：1.665-4.156，P<.001）值是预测术后心房颤动的独立预测因素。
在这项研究中，我们表明在右冠状动脉疾病患者中，RCGS 和 SII 值是 CABG 术后发生 PoAF 的独立预测因素。
