Wang Aiwen, Yuan Zhuo, Bu Xingpeng, Bi Shuzhen, Cheng Yadong, Chen Huanzhen
First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, 030000, People's Republic of China.
Department of Emergency, Changzhi People's Hospital, Changzhi, Shanxi, 046000, People's Republic of China.
Ther Clin Risk Manag. 2024 Oct 2;20:711-718. doi: 10.2147/TCRM.S473886. eCollection 2024.
Our study evaluated the risk factors for new postoperative atrial fibrillation (POAF) by analyzing the data collected from patients who underwent first coronary artery bypass grafting (CABG).
Our study retrospectively collected data from January 2021 to December 2023 at Changzhi People's Hospital. The perioperative period data were collected, and logistic regression was used to analyze the independent predictors of the occurrence of POAF after CABG and the related predictive values of risk factors were analyzed by using the subjects' work characteristic curve (ROC).
A total of 169 patients were included, and there are 45 patients in the POAF group, with an incidence of 26.6%, and 124 in the non-POAF group. The POAF group was significantly higher than the non-POAF group in terms of age (69.2±8.8 years vs 62.3±9.3 years) and preoperative LAD (42.7±7.2mm vs 36.8±5.5mm), and the difference was significant (P<0.05). Preoperative HDL-C in the POAF group were lower than non-POAF group (1.0±0.5 mmol/l vs 1.4±0.7 mmol/l, P<0.05). The logistic regression analysis revealed a significant correlation between age, LAD, HDL-C and the occurrence of POAF (P<0.05). According to the ROC curve analysis, age >64.5 years, LAD >41mm, and HDL-C <0.9 mmol/l were the cut-off values for predicting the occurrence of POAF (AUC1=0.733; AUC2=0.741; AUC3=0.647, P < 0.05). The combined age + LAD + HDL-C (AUC = 0.755; P < 0.05) had a higher diagnostic value and high sensitivity.
The age, LAD, and HDL-C are independent risk factors for the POAF after CABG, and clinicians should assess these risk factors as much as possible when managing patients in the perioperative period and make corresponding measures to prevent the development of POAF.
本研究通过分析首次接受冠状动脉旁路移植术（CABG）患者收集的数据，评估术后新发房颤（POAF）的危险因素。
本研究回顾性收集了长治市人民医院2021年1月至2023年12月的数据。收集围手术期数据，采用逻辑回归分析CABG术后POAF发生的独立预测因素，并利用受试者工作特征曲线（ROC）分析危险因素的相关预测价值。
共纳入169例患者，POAF组45例，发生率为26.6%，非POAF组124例。POAF组在年龄（69.2±8.8岁 vs 62.3±9.3岁）和术前左房内径（LAD）（42.7±7.2mm vs 36.8±5.5mm）方面显著高于非POAF组，差异有统计学意义（P<0.05）。POAF组术前高密度脂蛋白胆固醇（HDL-C）低于非POAF组（1.0±0.5 mmol/l vs 1.4±0.7 mmol/l，P<0.05）。逻辑回归分析显示年龄、LAD、HDL-C与POAF的发生有显著相关性（P<0.05）。根据ROC曲线分析，年龄>64.5岁、LAD>41mm和HDL-C<0.9 mmol/l是预测POAF发生的截断值（AUC1=0.733；AUC2=0.741；AUC3=0.647，P<0.05）。年龄+LAD+HDL-C联合检测（AUC = 0.755；P < 0.05）具有更高的诊断价值和高敏感性。
年龄、LAD和HDL-C是CABG术后POAF的独立危险因素，临床医生在围手术期管理患者时应尽可能评估这些危险因素，并采取相应措施预防POAF的发生。
