Qin Haokai, Luo Jiyuan, Yang Yunxiao, Feng Xunxun, Yang Xiubin, Hua Kun, Zhou Mingyang
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Chinese Institutes for Medical Research, Beijing, 100069, China.
BMC Womens Health. 2025 Aug 28;25(1):411. doi: 10.1186/s12905-025-03941-7.
Early menopause is considered directly related to the occurrence of isolated atrial fibrillation. In this study, we aim to explore the relationship between early menopause and the incidence of postoperative atrial fibrillation (POAF) occurring following coronary artery bypass grafting (CABG).
This retrospective cohort study included patients who underwent CABG at Beijing Anzhen Hospital from January 2020 to December 2023. Patients were divided into two cohorts: early menopausal individuals (age < 45) and non-early menopausal individuals (age ≥ 45). Baseline characteristic disparities were adjusted via including all baseline variables with an standardized mean difference (SMD) > 0.1 as covariates in the inverse probability of treatment weighting (IPTW) analysis. The correlation between menopausal age and the occurrence of POAF was analyzed utilizing logistic regression and restricted cubic spline (RCS).
Among the 1825 female patients who underwent CABG in this study, 537 developed POAF. After IPTW analysis to control for baseline variables, it was found that the incidence of POAF in the early menopause group was significantly higher than in the non-early menopause group (42.1% vs. 28.2%). Logistic regression analysis showed that early menopause was associated with an increased risk of POAF (adjusted OR: 1.76, 95% CI: 1.30-2.38, p < 0.001). RCS analysis also confirmed our hypothesis, showing that early menopause is associated with an increased risk of POAF.
Female CABG patients with early menopause have a higher incidence of POAF compared to those without early menopause. Additionally, the younger the age at menopause, the higher the risk of developing POAF. These findings suggest that menopausal age should be considered in preoperative risk stratification, and early menopausal women may benefit from targeted monitoring or preventive strategies to reduce POAF risk.
早发性绝经被认为与孤立性房颤的发生直接相关。在本研究中，我们旨在探讨早发性绝经与冠状动脉旁路移植术（CABG）后发生的术后房颤（POAF）发生率之间的关系。
这项回顾性队列研究纳入了2020年1月至2023年12月在北京安贞医院接受CABG的患者。患者被分为两个队列：早发性绝经个体（年龄<45岁）和非早发性绝经个体（年龄≥45岁）。通过将所有标准化均数差值（SMD）>0.1的基线变量作为协变量纳入治疗权重逆概率（IPTW）分析来调整基线特征差异。利用逻辑回归和限制性立方样条（RCS）分析绝经年龄与POAF发生之间的相关性。
在本研究中接受CABG的1825名女性患者中，537人发生了POAF。在进行IPTW分析以控制基线变量后，发现早发性绝经组的POAF发生率显著高于非早发性绝经组（42.1%对28.2%）。逻辑回归分析表明，早发性绝经与POAF风险增加相关（调整后的OR：1.76，95%CI：1.30 - 2.38，p<0.001）。RCS分析也证实了我们的假设，表明早发性绝经与POAF风险增加相关。
与没有早发性绝经的女性CABG患者相比，早发性绝经的女性患者POAF发生率更高。此外，绝经年龄越小，发生POAF的风险越高。这些发现表明，在术前风险分层中应考虑绝经年龄，早发性绝经女性可能从针对性监测或预防策略中受益，以降低POAF风险。
