Overweight and aging increase the risk of atrial fibrillation after cardiac surgery independently of left atrial size an
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(2020) 15:316
RESEARCH ARTICLE
Open Access
Overweight and aging increase the risk of atrial fibrillation after cardiac surgery independently of left atrial size and left ventricular ejection fraction Pier Luigi Stefàno1,2, Marco Bugetti1, Guido Del Monaco1, Gloria Popescu1, Paolo Pieragnoli1, Giuseppe Ricciardi1, Laura Perrotta1, Luca Checchi1, Roberto Rondine1, Sergio Bevilacqua1, Carlo Fumagalli1,2, Niccolò Marchionni1,2 and Antonio Michelucci1,2*
Abstract Background: Body mass index (BMI), age, left atrium (LA) dimension and left ventricular ejection fraction (LVEF) have been linked to post-operative atrial fibrillation (POAF) after cardiac surgery. The aim of this study was to better define the role of these risk factors. Methods: This retrospective cohort study evaluated 249 patients (without prior atrial dysrhythmia) undergoing cardiac or aortic surgery. Prior to surgery, the following data were collected: age, BMI, LA diameter, LA area, LVEF, thyroid stimulating hormone (TSH), creatinine and the presence of arterial hypertension (AH) and diabetes. Intraoperative data such as operation time, total clamp time, cardiopulmonary bypass time, and presence of pericardial/pleural effusion were also collected. Only patients without pre- and post-surgery prophylactic antiarrhythmic therapy were included. Results: Patients with (N = 127, 51%) and without POAF (N = 122, 49%) were compared. No difference was observed for sex, LA diameter, LA area, LVEF, TSH, diabetes and use of ACE inhibitors or statins prior to intervention. Moreover, no difference was observed in terms of operation time, total clamp time, cardiopulmonary bypass time, and presence of pericardial/pleural effusion. However, patients with POAF were older (70.6 ± 10.7 vs. 60.4 ± 16.4 years, p = 0.001), had higher BMI (26.8 ± 4.5 vs. 24.9 ± 3.6 kg/m2, p = 0.001), higher baseline creatinine (1.06 ± 0.91 vs. 0.88 ± 0.32 mg/dL, p = 0.038) and a higher frequency of arterial hypertension (73.2% vs. 50%, p = 0.001) and Bentall procedure (24.4% vs. 9.8%, p = 0.023). Multivariate analysis showed that the only independent predictors of POAF were age (OR = 1.05, 95%CI 1.02–1.07, p = 0.001) and BMI (OR = 1.11 95%CI 1.03–1.2,p = 0.006). Conclusions: These findings suggest that advanced age and a higher BMI are strong risk factors for POAF in patients without previous AF even in the presence of comparable LA dimensions and LVEF. Keywords: Postoperative atrial fibrillation, Cardiac surgery, Risk factors
* Correspondence: [email protected] 1 Department of Cardiothoracovascular Medicine, Careggi University Hospital (AOUC), Largo Brambilla, 3, 50134 Florence, Italy 2 Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, Florence 50134, Italy © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) an
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