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Postoperative hyperglycemia and atrial fibrillation after coronary artery bypass graft surgery

Wataru Tatsuishi1, Hitoshi Adachi, Makoto Murata

  • 1Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East, Tokyo; Department of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Japan. wataru0812_drt@ybb.ne.jp

Circulation Journal : Official Journal of the Japanese Circulation Society
|November 14, 2014
PubMed

Insights

High postoperative blood sugar (BS) and drainage volume are key risk factors for atrial fibrillation (AF) after coronary artery bypass grafting (CABG). Intensive glycemic control may help reduce AF occurrence in these patients.

Area of Science:

  • Cardiology
  • Metabolic Medicine
  • Surgical Complications

Background:

  • Postoperative atrial fibrillation (AF) is a frequent complication following coronary artery bypass grafting (CABG).
  • Identifying risk factors for AF post-CABG is crucial for patient management.
  • The relationship between blood sugar concentration (BS) and AF after CABG requires further investigation.

Purpose of the Study:

  • To investigate the risk factors for postoperative AF after CABG.
  • To analyze the association between postoperative blood sugar concentration and AF incidence.
  • To determine a potential BS threshold for predicting AF occurrence.

Main Methods:

  • Retrospective analysis of 199 patients undergoing isolated CABG.
  • Classification of patients based on the presence or absence of postoperative AF.
  • Statistical analysis including univariate and multivariate assessments of risk factors.

Main Results:

  • Mean postoperative BS, drainage volume, age, diabetes mellitus (DM), and estimated glomerular filtration rate were significant risk factors on univariate analysis.
  • Mean postoperative BS, drainage volume, and age remained significant risk factors on multivariate analysis.
  • Postoperative AF occurred more frequently in patients with higher BS (cut-off 180 mg/dl), irrespective of DM, with a strong correlation between maximum BS and AF onset.

Conclusions:

  • Mean postoperative BS and drainage volume are significant risk factors for AF post-CABG.
  • Postoperative AF is strongly associated with elevated maximum postoperative BS.
  • Intensive glycemic control is a potential strategy to reduce AF occurrence after CABG.
Abstract

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