Potentially Risk Factors for New Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Grafting: A Retrospective Cohort Study

Aiwen Wang,1,2 Zhuo Yuan,3 Xingpeng Bu,1 Shuzhen Bi,2 Yadong Cheng,4 Huanzhen Chen5 1First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, 030000, People’s Republic of China; 2Department of Emergency, Changzhi People’s Hospital, Changzhi, Shanxi, 046000, People’s Republic of China; 3Changzhi Medical College, Changzhi, Shanxi, 046000, People’s Republic of China; 4Department of Critical Care Medicine, Changzhi People’s Hospital, Changzhi, Shanxi, 046000, People’s Republic of China; 5Department of Cardiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030000, People’s Republic of ChinaCorrespondence: Huanzhen Chen, Department of Cardiology, The First Hospital of Shanxi Medical University, No. 56, Xinjian South Road, Yingze District, Taiyuan City, 030000, Shanxi, People’s Republic of China, Email [email protected]: Our study evaluated the risk factors for new postoperative atrial fibrillation (POAF) by analyzing the data collected from patients who underwent first coronary artery bypass grafting (CABG).Methods: Our study retrospectively collected data from January 2021 to December 2023 at Changzhi People’s Hospital. The perioperative period data were collected, and logistic regression was used to analyze the independent predictors of the occurrence of POAF after CABG and the related predictive values of risk factors were analyzed by using the subjects’ work characteristic curve (ROC).Results: A total of 169 patients were included, and there are 45 patients in the POAF group, with an incidence of 26.6%, and 124 in the non-POAF group. The POAF group was significantly higher than the non-POAF group in terms of age (69.2± 8.8 years vs 62.3± 9.3 years) and preoperative LAD (42.7± 7.2mm vs 36.8± 5.5mm), and the difference was significant (P< 0.05). Preoperative HDL-C in the POAF group were lower than non-POAF group (1.0± 0.5 mmol/l vs 1.4± 0.7 mmol/l, P< 0.05). The logistic regression analysis revealed a significant correlation between age, LAD, HDL-C and the occurrence of POAF (P< 0.05). According to the ROC curve analysis, age > 64.5 years, LAD > 41mm, and HDL-C < 0.9 mmol/l were the cut-off values for predicting the occurrence of POAF (AUC1=0.733; AUC2=0.741; AUC3=0.647, P < 0.05). The combined age + LAD + HDL-C (AUC = 0.755; P < 0.05) had a higher diagnostic value and high sensitivity.Conclusion: The age, LAD, and HDL-C are independent risk factors for the POAF after CABG, and clinicians should assess these risk factors as much as possible when managing patients in the perioperative period and make corresponding measures to prevent the development of POAF.Keywords: coronary artery bypass grafting, left atrial diameter, left ventricular ejection fraction, high density lipoprotein cholesterol, atrial fibrillation