Analysis of risk factors for postoperative atrial fibrillation in elderly patients with coronary heart disease after off-pump coronary artery bypass grafting surgery

Abstract

Objective To investigate certain risk factors for postoperative atrial fibrillation (AF) in elderly patients with coronary heart disease after off-pump coronary artery bypass grafting(OPCAB)surgery in order to provide a basis for the prevention and treatment of AF after OPCAB. Methods A total of 139 elderly patients with coronary heart disease who had undergone OPCAB surgery in our hospital were collected as research subjects and divided into the AF group and the non-AF group according to the occurrence of AF after operation. The patients' general information and clinical data were retrospectively analyzed. Risk factors for AF after OPCAB surgery in elderly patients with coronary heart disease were investigated. Results The incidence of AF after OPCAB was 15.8% in elderly patients with coronary heart disease. There were no statistical differences in gender, history of diabetes, history of myocardial infarction, preoperative β-blocker usage, number of coronary artery lesions, or operation time between the AF group and the non-AF group (P>0.05). The percentage of patients who were of older age (t=-9.960) or had a left ventricular ejection fraction ≥40% (χ2=4.942), a left atrial diameter ≥40 mm (χ2=4.491), a history of hypertension (χ2=12.357), dopamine medication after operation (χ2 =8.511), or a bypass vessel count≥3 (χ2=5.385) was higher in the AF group than in the non-AF group (all P<0.05). Logistic regression analysis showed that age, history of hypertension, dopamine medication after operation, left atrial diameter and bypass vessel count were the risk factors for AF after OPCAB surgery in elderly patients with coronary heart disease (OR=3.080, 2.435, 2.465, 3.593, and 1.921, respectively, P<0.05 for all). Conclusions The incidence of AF after OPCAB is high in elderly patients with coronary heart disease and is affected by many risk factors. These risk factors should be assessed before surgery so that appropriate prevention measures can be taken. Key words: Coronary artery disease; Coronary artery bypass, off-pump; Atrial fibrillation