Effect of vitamin D deficiency on the development of postoperative atrial fibrillation in coronary artery bypass patients.

Safa Gode,Timuçin Aksu,Mehmet Gul,Ihsan Bakır,Mehmet Yeniterzi,Aylin Demirel,Murat Sunbul

doi:10.15171/jcvtr.2016.29

Abstract

Introduction: Various factors may be responsible for the development of postoperative atrial fibrillation (POAF) in coronary artery bypass graft (CABG) patients. In our study, we demonstrated the effect of vitamin D deficiency on the development of POAF. Methods: In this prospective case control study, patients undergoing elective, isolated CABG were considered. A total of 15 patients (16.6%) who developed POAF during the first five days after surgery made up the POAF group. Seventy-five patients that had a sinus rhythm in the same period were the non-POAF group. The two groups were compared statistically in terms of laboratory, clinical, echocardiographic, operative, and postoperative parameters. Results: All patients were in sinus rhythm at discharge. The baseline characteristics of the study groups were comparable. The POAF group had a lower vitamin D level than the non-POAF group (9.0 ± 5.0 and 15.0 ± 8.4 ng/mL, respectively; P=0.007). In the POAF group, the patients’ left atrium diameter and incidence of hypertension (HT) were higher than those of the non-POAF group. Conclusion: Incidence of POAF was significantly higher in patients with vitamin D deficiency or insufficiency than the patients with vitamin D level in normal range. Therefore vitamin D deficiency or insufficiency may be a predictor of POAF in patients with CABG.

Highlights

Various factors may be responsible for the development of postoperative atrial fibrillation (POAF) in coronary artery bypass graft (CABG) patients
A comparison was made between groups based upon their clinical diagnoses and admission medications, including ACE inhibitors, beta blockers, calcium channel blockers and statins, and the incidence of HT was significantly higher in the POAF group (P = 0.029) (Table 1)
No difference was reported in the number of bypassed vessels, total perfusion time (TPT), and aortic cross clamp time (ACCT) (Table 3)

Summary

Introduction

Postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass graft (CABG). Vitamin D deficiency on development of POAF five days postoperatively in patients with on pump CABG. AF diagnostic criteria including that absence of discrete P waves, the RR inter- In this prospective, case control study, patients undergo- “irregularly irregular” and the ranges of ventricular rate ing elective primary isolated CABG at the Department of usually between 90 and 170 beats/min were considered for Cardiothoracic Surgery of Istanbul Mehmet Akif Ersoy POAF by a cardiologist in our study. Hyperthyroidism was parison was performed between the groups in terms defined as a blood thyroid stimulating hormone (TSH) of their parathyroid hormone (PTH), vitamin D and other level of

Results

Discussion

Limitations

Conclusion