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Obesity and metabolic syndrome are independent risk factors for atrial fibrillation after coronary artery bypass graft surgery.

Najmeddine Echahidi1, Dania Mohty, Philippe Pibarot

  • 1Department of Medicine, Laval University, Quebec, Canada.

Circulation
|September 14, 2007

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View abstract on PubMed

Summary

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  • Biomedical And Clinical Sciences
  • Oncology And Carcinogenesis
  • Predictive And Prognostic Markers
  • Obesity And Metabolic Syndrome Are Independent Risk Factors For Atrial Fibrillation After Coronary Artery Bypass Graft Surgery.
    • This summary is machine-generated.

    Obesity is a significant risk factor for postoperative atrial fibrillation (POAF) in patients over 50 undergoing cardiac surgery. In younger patients, metabolic syndrome (MS) is the primary predictor of POAF.

    Area of Science:

    • Cardiology
    • Metabolic Health
    • Surgical Outcomes

    Background:

    • Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery.
    • Obesity is a known risk factor for POAF, but the role of metabolic syndrome (MS) remains unclear.

    Purpose of the Study:

    • To investigate the association between obesity, metabolic syndrome (MS), and the incidence of new-onset POAF in patients undergoing coronary artery bypass grafting (CABG).

    Main Methods:

    • Retrospective analysis of 5085 patients undergoing isolated CABG.
    • Assessment of obesity (BMI ≥ 30 kg/m²) and MS (NCEP-ATPIII criteria).
    • Statistical analysis to determine the independent association of obesity and MS with POAF incidence, stratified by age (≤ 50 vs. > 50 years).

    Main Results:

    • POAF occurred in 27% of patients.
    • Obesity was associated with increased POAF risk in the overall cohort and in patients > 50 years.
    • In patients ≤ 50 years, MS, not obesity, was significantly associated with a higher incidence of POAF (12% vs. 6%, P=0.01).
    • For patients > 50 years, moderate-severe obesity (BMI ≥ 35 kg/m²) independently increased POAF risk by 2.3-fold.
    • For patients ≤ 50 years, MS independently increased POAF risk by 2.36-fold (RR: 2.36; 95% CI: 1.10 to 5.12; P=0.02).

    Conclusions:

    • Obesity is a strong independent risk factor for POAF in patients over 50 undergoing CABG.
    • In younger patients (≤ 50 years), MS is the primary metabolic risk factor independently associated with POAF, while obesity is not.
    • These findings highlight age-specific risk factors for POAF after cardiac surgery.

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