摘要
Objectives:Reported prediction rules for postoperative atrial fibrillation(AF)have suffered from inconsistent results and controversy surrounding the predictive value of a preoperative P-wave duration(PreOPWD).This study examined PreOPWD as a predictor for AF after coronary artery bypass grafting(CABG).Methods:Two-hundred-and-ninety-nine patients with sinus rhythm before off-pump CABG were recruited into the study.Patients'demographic and clinical data were evaluated prospectively.Patients were continuously monitored for the first seven postoperative days.Multiple logistic regressionwas used to determine significant predictors of AF.Findings were then combined with similar studies and a metaanalysis was performed.Results:Postoperative AF was observed in 33.1%of 299 patients.Patients with AF were older,had a prolonged PreOPWD,higher incidences of hypertension,aortic regurgitation,and mitral regurgitation.A cut-off point of PreOPWD105ms achieved a specificity of 74%,and a sensitivity of 65%for predictive of AF.Multivariate analysis showed that PreOPWD105ms(odds ratio[OR]4.63,95%confidence intervals[CI]2.66 to 8.03,P<0.001),age60 years(OR 2.72,95%CI 1.51 to 4.90,P<0.01)and hypertension(OR 2.10,95%CI 1.08 to 4.07,P<0.05)independently predicted postoperative AF.A meta-analysis of this data combined with those of ten other studies showed that PreOPWD was greater in patients with POAF,with a weighted mean difference of 3.95 ms(95%CI 1.97 to 5.92,P<0.001).Conclusion:This study confirmed,among other predictive characteristics,that PreOPWD is a powerful independent predictor of POAF.
基金
This work was supported by the National Natural Science Foundation of China[30871049]
The sponsor had no role in the design,data collection,data analysis,data interpretation,or writing of this report.
