Preoperative poor coronary collateral circulation can predict the development of atrial fibrillation after coronary artery bypass graft surgery
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Hasan Gungor1, Ufuk Eryilmaz, Cagdas Akgullu
1Departments of aCardiology bCardiovascular Surgery, Faculty of Medicine, Adnan Menderes University, Aydin cDepartment of Cardiology, Malatya Hospital, Malatya, Turkey.
Insights
Poor coronary collateral circulation (CCC) significantly increases the risk of developing atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery. This finding highlights CCC as a key predictor for post-CABG AF.
Area of Science:
- Cardiology
- Cardiac Surgery
- Arrhythmia Research
Background:
- Coronary collateral circulation (CCC) protects the myocardium during ischemia and reduces cardiovascular events.
- Atrial fibrillation (AF) is a common complication following coronary artery bypass graft (CABG) surgery.
Purpose of the Study:
- To investigate the association between preoperative coronary collateral circulation (CCC) and the incidence of atrial fibrillation (AF) in patients undergoing CABG surgery.
Main Methods:
- 165 patients undergoing CABG were assessed for preoperative CCC using the Rentrop method.
- Patients were divided into poor CCC and good CCC groups.
Main Results:
- The incidence of AF was substantially higher in the poor CCC group (49%) compared to the good CCC group (14%).
- Poor CCC grade was identified as an independent predictor of AF development post-CABG, with an odds ratio of 11.500.
Conclusions:
- Preoperative coronary collateral circulation status is a significant predictor of postoperative atrial fibrillation after CABG.
- Identifying patients with poor CCC may aid in risk stratification and management strategies for post-CABG AF.
Aim:
Coronary collateral circulation (CCC) helps to protect and preserve myocardium from episodes of ischemia, and reduce angina symptoms, arrhythmia, and cardiovascular events. Atrial fibrillation (AF) is the most frequent form of arrhythmia after coronary artery bypass graft (CABG) surgery. The aim of this study was to investigate the association between CCC and the development of AF in patients undergoing CABG surgery.
Methods:
A total of 165 patients (mean age 63±10 years, 74% men, 26% women) who were undergoing CABG surgery at our department were enrolled into this study. Patients were categorized into two groups according to preoperative CCC using the Rentrop method.
Results:
Of the patients, 79 had poor CCC and 89 had good CCC. The AF incidence rate in the poor collateral group was significantly higher than that in the good collateral group [37 (49%) vs. 12 (14%), P<0.001]. In univariate analysis, age, left atrium size, and poor CCC grade were associated with AF after CABG surgery. Multivariate analysis showed that only poor CCC grade (odds ratio: 11.500; 95% confidence interval 3.977-33.253, P<0.001) was an independent predictor of the development of AF after adjustment of other potential confounders in patients undergoing CABG surgery.
Conclusion:
The present study showed that preoperative poor CCC is a powerful predictor of the development of AF after CABG surgery.
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