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Is Left Atrial Size a Predictor of Mortality after Coronary Artery Bypass Surgery? A Single Center Study
Khalid S Ibrahim1, Fadia A Mayyas2, Khalid Kheirallah3
1Princess Muna Heart Center, King Abdullah University Hospital; ; Department of General Surgery, Division of Cardiac Surgery, Faculty of Medicine.
Insights
Enlarged left atrial size is a significant predictor of mortality after coronary artery bypass surgery (CABG). This finding highlights the importance of assessing left atrial (LA) size in patients undergoing CABG.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Research
Background:
- Coronary artery bypass surgery (CABG) is a common procedure.
- Predictors of mortality following CABG are crucial for patient management.
- Left atrial (LA) size has been investigated as a potential prognostic factor.
Purpose of the Study:
- To determine if left atrial (LA) size independently predicts mortality after coronary artery bypass surgery (CABG).
- To identify key risk factors associated with 30-day mortality post-CABG.
Main Methods:
- A single-center study analyzed 1070 patients undergoing isolated CABG between 2005-2014.
- Clinical, laboratory, and demographic data were collected.
- Multivariate logistic regression models assessed the impact of enlarged LA size (≥ 4 cm) on 30-day mortality, controlling for collinearity.
Main Results:
- Enlarged LA size was a significant independent predictor of 30-day mortality (OR 4.82, 95% CI 2.16-10.79) in Model A.
- Other independent predictors included emergency CABG, prolonged inotropic support, long-term diuretic use, and pre-operative clopidogrel use.
- In Model B, enlarged LA size and moderate mitral regurgitation were significant predictors.
Conclusions:
- Increased left atrial (LA) size is a strong, independent predictor of mortality after isolated coronary artery bypass surgery (CABG).
- LA size assessment may improve risk stratification for patients undergoing CABG.
Background:
To investigate the left atrial (LA) size as an independent predictor of mortality following coronary artery bypass surgery (CABG).
Methods:
This single center study evaluated determinants of mortality in 1070 patients who underwent isolated CABG from 2005-2014. Clinical, laboratory and demographic data were obtained from medical records. Collinearity between enlarged LA size (diameter ≥ 4 cm) and covariates was identified. The adjusted effects of enlarged LA size on 30-day mortality post CABG were tested using multiple logistic regression models. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were reported.
Results:
The mean age was 59 ± 9.8 years, and 238 patients were female. Two multivariate logistic regression models were evaluated. In Model A, mitral regurgitation (MR), ejection fraction, intensive care unit length-of-stay and variables found to be collinear with LA size as predictors of mortality were excluded. In model B, the collinear variables were included. By multivariate analysis (Model A), the statistically significant independent predictors of 30-day mortality after CABG were: enlarged LA size (OR 4.82, 95% CI 2.16-10.79), emergency CABG (OR 3.54, 95% CI 1.75-7.18), prolonged inotropic support (OR 2.79, 95% CI 1.38-5.6), diuretic use ≥ 1 month (OR 1.29, 95% CI 1.3-8.42), and use of clopidogrel within a week before surgery (OR 3.27, 95% CI 1.28-8.36. In Model B, enlarged LA and moderate MR were identified as independent predictors of 30-day mortality.
Conclusions:
Increased LA size is a strong independent predictor of mortality after isolated CABG.
