Effect of preoperative obstructive sleep apnea on the frequency of atrial fibrillation after coronary artery bypass grafting
| Autor: | Shetuan Zhang, Andrew Hamilton, Wilma M. Hopman, Dimitri Petsikas, Darrin Payne, Adrian Baranchuk, Damian P. Redfearn, Erik M. van Oosten |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Coronary Artery Disease Electrocardiography Postoperative Complications Risk Factors Internal medicine Atrial Fibrillation medicine Prevalence Humans Continuous positive airway pressure Prospective Studies Coronary Artery Bypass Prospective cohort study Aged Ontario Sleep Apnea Obstructive medicine.diagnostic_test business.industry Incidence Sleep apnea Atrial fibrillation Middle Aged medicine.disease Prognosis Obstructive sleep apnea Survival Rate PCAF Preoperative Period Cardiology Female Cardiology and Cardiovascular Medicine Complication business Follow-Up Studies |
| Zdroj: | The American journal of cardiology. 113(6) |
| ISSN: | 1879-1913 |
| Popis: | Patients with obstructive sleep apnea (OSA) have intermittent hypoxia leading to atrial remodeling and this has been associated with the development of atrial fibrillation (AF). Postoperative AF is a common complication of coronary artery bypass grafting (CABG). The aim of this prospective study was to determine whether the presence of OSA predicts the occurrence of post-CABG AF (PCAF). This was a prospective single-center study. Patients undergoing elective CABG were evaluated and categorized as confirmed, high-risk, or low-risk OSA according to a modified Berlin questionnaire. PCAF was evaluated by 24-hour cardiac monitoring strip or 12-lead electrocardiography during the postoperative period, and validated by an electrophysiologist. We included 277 patients. OSA prevalence was 47.7%, with body mass index (31.0 vs 26.9 kg/m 2 , p ≤0.001), advanced age (63.7 vs 66.4 years, p = 0.031), hypertension (78.0% vs 64.8%, p = 0.015), and diabetes (45.5% vs 28.3%, p = 0.003) more prevalent in the OSA group. PCAF was found to occur in 37.2% of all patients and OSA was found to be a strong predictor of PCAF (45.5% vs 29.7%, p = 0.007). PCAF was also associated with continuous positive airway pressure use (12.6% vs 5.2%, p = 0.027). Increased length of stay was associated with PCAF (6.5 vs 5.3 days, p = 0.006), as was longer time from surgery to occurrence of PCAF (p = 0.001). In conclusion, OSA was found to be a strong predictor of PCAF, which in turn was found to be associated with increased length of stay. |
| Databáze: | OpenAIRE |
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