New-Onset Post-Operative Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Grafting Surgery - A Retrospective Case-Control Study.
New-Onset Post-Operative Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Grafting Surgery - A Retrospective Case-Control Study.
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DOI：
10.21470/1678-9741-2021-0220
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发表时间：
2023-02-10
影响因子：
1.3
通讯作者：
Wang, Dongjin
中科院分区：
文献类型：
--
作者：
Cui, Xuehui;Xu, Can;Chen, Cheng;Su, Yunyan;Li, Jie;He, Xiaojun;Wang, Dongjin
关键词：
术后新发心房颤动（POAF）是冠状动脉旁路移植术（CABG）后常见的并发症。探讨孤立性非体外循环冠状动脉旁路移植术（CABG）患者新发POAF的预测因素和潜在机制。回顾性观察性病例对照研究，纳入2018年8月至2020年7月在南京大学医学院附属鼓楼医院胸心外科行隔离非体外循环CABG手术的233例患者。预测变量和新发POAF之间的关联被确定。主要结局为CABG术后新发POAF。共有75例（32.19%）患者在CABG术后新发POAF。新发POAF患者年龄较大、基线收缩压较高、术前利尿药使用较多、血液制品输注较多、心房扩张较多、术后正性肌力药物治疗较多。19个变量进入多变量logistic回归模型，Hosmer-Lemeshow检验得分为7.565（P=0.477）。术后左房增大、术后24 h引流量及总住院时间有统计学意义，而术后右房增大（OR和95% CI，7.797 [0.200，304.294]，P=0.272）和左房扩大（3.524 [1.141，10.886]，P=0.029）的OR值最大。孤立性非体外循环冠状动脉旁路移植术患者的心房扩大与新发POAF密切相关，因此，它突出了超声心动图作为预测新发POAF的有用工具的优势。应考虑对这些患者进行仔细监测和及时干预。
New-onset postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG) surgery. To explore predictive factors and potential mechanisms of new-onset POAF in isolated off-pump CABG patients. Retrospective observational case-control study of 233 patients undergoing isolated off-pump CABG surgery between August 2018 and July 2020 at the Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School. Associations between predictor variables and new-onset POAF were identified. The main outcome was new-onset POAF after CABG surgery. A total of 75 (32.19%) patients developed new-onset POAF after CABG surgery. The new-onset POAF patients had advanced age, higher baseline systolic blood pressure, more preoperative use of diuretic drug, more transfusion of blood products, atrial dilation and postoperative positive inotropic drug treatment. Nineteen variates entered the multivariable logistic regression model with a Hosmer-Lemeshow test score of 7.565 (P=0.477). Postoperative left atrial enlargement, postoperative drainage in the first 24 hours and total length of hospital stay were statistically significant, while postoperative right atrial enlargement (OR and 95% CI, 7.797 [0.200, 304.294], P=0.272) and left atrial enlargement (3.524 [1.141, 10.886], P=0.029) assessed by echocardiography had the largest OR value. Atrial enlargement is strongly associated with new-onset POAF in patients with isolated off-pump CABG, thus it highlights the advantage of echocardiography as a useful tool for predicting new-onset POAF. Careful monitoring and timely intervention should be considered for these patients.
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影响因子：
1.3
作者：
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通讯作者：
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影响因子：
37.8
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影响因子：
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作者：
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通讯作者：
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影响因子：
5.4
作者：
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通讯作者：
Jeppsson A
影响因子：
6.2
作者：
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通讯作者：
Voigt, Jens-Uwe