Abstract
Objective The aim of this study was to evaluate the value of CHA2DS2-VASc and Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) risk scores for prediction of postoperative atrial fibrillation (AF) development in patients undergoing coronary artery bypass grafting (CABG) operation.Methods The population of this observational study consisted of 370 patients undergoing CABG operation. CHA2DS2-VASc and ATRIA risk scores were calculated for all patients and their association with postoperative AF (AF episode lasting > 5 min) were evaluated. Predictors of postoperative AF were determined by multiple logistic regression analysis.Results During follow-up, 110 patients (29.7%) developed postoperative AF. With multiple logistic regression analysis, risk factors for postoperative AF were determined: ATRIA risk score (odds ratio [OR] 1.23; 95% confidence interval [CI] 1.11-1.36; P<0.001), fasting glucose level (OR 1.006; 95% CI 1.004-1.009; P<0.001), and 24-hour drainage amount (OR 1.002; 95% CI; 1.001-1.004; P<0.001). Receiver operating characteristic curve analyses showed that CHA2DS2-VASc and ATRIA risk scores were significant predictors for new-onset AF (C-statistic 0.648; 95% CI 0.59-0.69; P<0.001; and C-statistic 0.664; 95% CI 0.61-0.71; P<0.001, respectively).Conclusion CHA2DS2-VASc and ATRIA risk scores predict new AF in patients undergoing CABG.
Highlights
Postoperative atrial fibrillation (POAF) is the most common type of arrhythmia after cardiac surgery with the incidence ranging from 10 to 65%, and its prevalence is even higher in elderly patients with heart failure and severe left ventricular impairment[1]
The current study showed that higher CHA2DS2-VASc and Atrial Fibrillation (ATRIA) scores were independently associated with the development of AF in patients undergoing coronary artery bypass grafting (CABG); both scores could be helpful and appropriate scoring systems for predicting AF after CABG
We demonstrated that CHA2DS2-VASc and ATRIA scoring systems could be used to determine patients at the highest risk of developing POAF, these scoring systems may decrease nonselective prophylaxis
Summary
Postoperative atrial fibrillation (POAF) is the most common type of arrhythmia after cardiac surgery with the incidence ranging from 10 to 65%, and its prevalence is even higher in elderly patients with heart failure and severe left ventricular impairment[1]. Patients with developing atrial fibrillation (AF) after cardiac surgery have higher risk for morbidity, such as cerebrovascular accidents, pulmonary edema, longer hospital stays, and mortality compared to those who do not develop AF[1]. Uysal D, et al - ATRIA and CHA2DS2-VASc Scores in Predicting POAF and taking necessary precautions will decrease the mortality and morbidity rates. Scoring systems should be developed to predict the development of POAF
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