冠状动脉旁路移植术后新发心房颤动的危险因素分析

Analysis of the risk factors of new-onset atrial fibrillation after coronary artery bypass grafting

目的探讨冠状动脉旁路移植(CABG)术后新发心房颤动(AF)的发生率以及相关危险因素。方法对2014年1月-2018年11月于徐州医科大学附属医院行CABG手术的247例冠心病患者的临床资料进行回顾性分析,根据术后是否新发AF分为AF组和NAF组,统计术后新发AF的发生率,多因素Logistic回归分析CABG术后新发AF的相关危险因素。结果CABG术后新发AF 59例,发生率为23.9%。多因素Logistic回归分析显示,年龄(OR=1.097,95%CI 1.038~1.159,P=0.001)、红细胞分布宽度(RDW)(OR=1.456,95%CI 1.003~2.113,P=0.048)、左房内径(LAD)(OR=1.251,95%CI 1.136~1.377,P<0.01)、CABG前二尖瓣舒张早期峰速/二尖瓣环侧壁处舒张早期峰速(E/E')(OR=1.172,95%CI 1.019~1.348,P=0.026)是CABG术后新发AF的独立危险因素。结论年龄、RDW、LAD、CABG前E/E'可能是术后新发AF的独立危险因素。因此应对患者进行早期评估,提前采取预防措施。

Objective To investigate the incidence and risk factors of new-onset atrial fibrillation(AF)after coronary artery bypass grafting(CABG).Methods A total of 247 patients with coronary heart disease who underwent CABG from January 2014 to November 2018 in the Affiliated Hospital of Xuzhou Medical University were enrolled and their clinical data were retrospectively analyzed.The patients were divided into an AF group and a NAF group,according to the onset of AF after surgery.The incidence of new-onset AF after CABG was calculated.Multivariate logistic regression analysis was performed to analyze the risk factors of new-onset AF after CABG.Results The incidence of postoperative new-onset AF was 23.9%(59/247).Multivariate logistic regression analysis showed that age(OR=1.097,95%CI 1.038-1.159,P=0.001),erythrocyte distribution width(RDW)(OR=1.456,95%CI 1.003-2.113,P=0.048),left atrial diameter(LAD)(OR=1.251,95%CI 1.136-1.377,P<0.01),and the ratio of early diastolic transmitral velocity to early diastolic mitral annular velocity(E/E')before CABG(OR=1.172,95%CI 1.019-1.348,P=0.026)were the independent risk factors for new-onset AF after CABG.Conclusions Age,RDW,LAD and E/E'before CABG may be independent risk factors for new-onset AF after CABG.