CHA2DS2-VASC SCORE RATHER THAN NEW-ONSET ATRIAL FIBRILLATION INFLUENCES STROKE RISK AFTER ISOLATED CORONARY ARTERY BYPASS GRAFTING - A NATIONWIDE STUDY

• Background Studies of resource utilization by patients with new-onset atrial fibrillation after coronary artery bypass grafting have addressed only length of stay and bed charges.• Objective To compare resource utilization between patients with new-onset atrial fibrillation and patients without atrial fibrillation after isolated coronary artery bypass grafting.• Methods Retrospective review of clinical and administrative electronic databases for 720 subjects who underwent isolated coronary artery bypass grafting with cardiopulmonary bypass in 25 months at one medical center. The prevalence of atrial fibrillation was determined, and resource utilization in various hospital cost centers was compared between subjects with and without atrial fibrillation.• Results The prevalence of new-onset atrial fibrillation was 33.1%. Compared with subjects without atrial fibrillation, subjects with atrial fibrillation had a longer stay (5.8 ± 2.4 vs 4.4 ± 1.2 days, P< .001), more days receiving mechanical ventilation (P=.002) and oxygen therapy (P< .001), and higher rates of readmission to the intensive care unit (4.6% vs 0.2%, P< .001). Subjects with atrial fibrillation also had more laboratory tests (P< .001) and more days receiving cardiac drugs, heparin, diuretics, and electrolytes. Subjects with atrial fibrillation had higher total postoperative charges ($57261 ± $17 101 vs $50 905 ± $10 062, P = .001), a mean difference of $6356. The mean differences were greatest for bed charges ($1642), laboratory charges ($1215), pharmacy ($989), and respiratory care ($582).• Conclusions The economic impact of atrial fibrillation after coronary artery bypass grafting has been underestimated.

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Excess long-term mortality in patients with new-onset atrial fibrillation following coronary artery bypass grafting

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2004.09.027 ◽

2004 ◽

Vol 44 (12) ◽

pp. 2415

Author(s):

Robert H. Habib ◽

Anoar Zacharias ◽

Thomas A. Schwann ◽

Christopher J. Riordan

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Onset Atrial Fibrillation ◽

Long Term Mortality ◽

New Onset

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Preexisting Chronic Kidney Disease and Dyslipidemia are Strong Predictors for Early Acute Cerebrovascular Event After Isolated Coronary Artery Bypass Grafting: A Single Cardiac Center Experience

ASEAN Heart Journal ◽

10.31762/ahj2029.0102 ◽

2020 ◽

Vol 29 (1) ◽

pp. 8-13

Author(s):

Leonardo Paskah Suciadi ◽

Andreas Hartanto Santoso ◽

Irvan Cahyadi ◽

Hoo Felicia Davina Hadi Gunawan ◽

Joshua Henrina Sudjaja ◽

...

Keyword(s):

Atrial Fibrillation ◽

Chronic Kidney Disease ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Kidney Disease ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Onset Atrial Fibrillation ◽

New Onset

The outcomes of coronary artery bypass grafting (CABG) surgery are determined by numerous factors. This study aimed to analyze the factors contributing to short-term outcomes of patients undergoing isolated CABG. This retrospective analysis enrolled all adult patients undergoing isolated CABG at our center between January 2013 and December 2016. Clinical characteristics and postoperative events were recorded and analyzed. Overall, 242 patients (mean age, 59.7 ± 9.5 years) were included. The majority of the patients (88.4%) were men. The median left ventricular ejection fraction (LVEF) was 50% ± 15%, with 38% patients having an LVEF lower than 40% and 9.1% having an LVEF lower than 25%. The mean preoperative creatinine level was 1.25 ± 0.73, and the estimated glomerular filtration rate was 68.55 ± 23 ml/min/1.73 m2. The intensive cardiac care unit stay and total in-hospital stay were 70 ± 59 h and 8 ± 4 days, respectively. The in-hospital mortality rate was 2.1%. The most common major adverse events were new-onset atrial fibrillation (31.8%) and significant worsening of renal function (21.5%). Stroke occurred in 3.7% patients, for which preexisting chronic kidney disease (CKD) and dyslipidemia were strong predictors (P < 0.05; area under the curve [AUC], 87.7%). Advanced age and hypertension were considered significant risk factors for developing new-onset atrial fibrillation (P < 0.05; AUC 65%). Worsening renal function and new-onset atrial fibrillation were the most frequent complications that occurred during hospitalization following CABG. Preexisting CKD and dyslipidemia were the major risk factors for developing acute stroke post surgery. KEYWORDS Acute cerebrovascular events, Chronic kidney disease, Coronary artery bypass grafting, Dyslipidemia.

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