Atrial fibrillation in the elderly old patients who underwent off-pump coronary artery bypass grafts surgery

Abstract

Objective To examine the incidence and risk factors associated with new onset atrial fibrillation (AF) in the elderly coronary heart disease patients who underwent off-pump coronary artery bypass (OPCAB) surgery. Methods From April 2012 to April 2014, 159 elderly patients received OPCAB in our hospital. The patients were divided into AF group and non-AF group. Statistic analyses were used to screen risk factors of new onset AF after OPCAB. Results The incidence of AF after OPCAB is 22.01%. Univariate analysis demonstrated that patients in AF group compared with those in non-AF group were more likely advanced age [(66.9±5.0)years vs. (64.9±3.7)years, P=0.009], preoperative SpO2 level (89.67%±6.14% vs. 92.00%±5.34%, P=0.029), preoperative EF (42.66%±7.51% vs. 45.94%±8.46%, P=0.039), the numbers of vascular grafting [(3.3±1.4)b vs. (2.7±1.2)b, P=0.017], postoperative 3 days BNP level [(2 276.45±1 281.82)pg/ml vs. (1 444.47±1 163.38)pg/ml, P=0.000], postoperative 3 days blood potassium level [(3.59±0.24)mmol/L vs. (4.01±0.62)mmol/L, P=0.000], postoperative 3 days serum calcium level [(2.31±0.21)mmol/L vs. (2.23±0.07)mmol/L, P=0.000], preoperative 3 days BNP level [(850.88±711.55)pg/ml vs. (523.20±682.57)pg/ml, P=0.014], hospitalization days [(21.5±5.4)d vs. (19.4±4.8)d, P=0.026]. Multivariate Logistic regression analyzes showed that age (OR: 0.87, 95%CI: 0.776-0.976), suffering from heart valve disease (OR: 0.149, 95%CI: 0.034-0.658), preoperative SpO2 level (OR: 1.092, 95%CI: 1.012-1.117), the numbers of vascular grafting (OR: 0.543, 95%CI: 0.349-0.845), postoperative 3 days BNP level (OR: 1.000, 95%CI: 0.999-1.000), postoperative 3 days blood potassium level (OR: 3.842, 95%CI: 1.227-12.029), postoperative 3 days serum calcium level (OR: 0.007, 95%CI: 0.000-0.520) were significantly related to AF. Conclusions Changes of perioperative electrolytes, decline in the oxygen saturation 65 years and the numbers of vascular grafting>3 are risk factors of new onset AF in the elderly coronary heart disease patients who underwent OPCAB surgery. Key words: Atrial fibrillation; Coronary artery disease; Coronary artery bypass, off-pump; Aged; Risk factors