"Is preoperative anemia a risk factor of new-onset atrial fibrillation in patients underwent isolated coronary artery bypass surgery?"

Abstract

Abstract:Aim: The impact of preoperative anemia in coronary artery bypass surgery (CABG) remains controversial and mostly associatedwith worse outcomes. Also, relationship between anemia and new on-set Atrial Fibrillation (NOAF) is still uncertain in patients whounderwent CABG. This study aimed to investigate the anemia whether a risk factor of NOAF in patients who underwent isolatedCABG.Material and Methods: Between March 2007 - December 2017 data of patients who underwent isolated CABG were retrospectivelyexamined and 2027 patients included in study. Anemia was defined as hemoglobin level < 13 g/dl for men and <12 g/dl for women.Patients were grouped as non-AF (n=1772) and AF (n=255) according to development of NOAF after CABG or not. Multivariatelogistic regression analysis was performed to determine AF risk factors.Results:Overall anemia incidence of this study was 25.8% (n= 522). Also, anemia was observed in 17.4% of males and 52.2% offemales. The incidence of anemia was similar in both groups; AF group 29% (n=74), non-AF group 25.3% (n=448) (p = 0.202). Themean hemoglobin and mean hematocrit level of AF and non-AF groups were similar (p=0.749, p=0.954 respectively) and 13.88 ±1.77 g/dl, 13.84±1.63 g/dl and 41.13±5.48 %, 41.15±4.97 % respectively. Multivariate logistic regression analysis revealed that theparameters of mean hemoglobin, mean hematocrit and preoperative anemia were not NOAF risk factors after CABG. The parametersof carotid artery disease (OR=1.996), low LVEF (OR=1.429), BUN (OR=1.019), Euroscore (OR=1.151), need of inotrop (OR=2.270),mean perfusion time (OR=1.008), mean crosclamp time (OR=1.007) and mean ventilation time (OR=1.030) were independent riskfactors of NOAF after CABG. Postoperative early mortality of groups were similar (p=0.299).Conclusion: Preoperative anemia was not a risk factor of NOAF in post-CABG patients. In addition, the mortality-enhancing effectof preoperative anemia was not detected in AF patients.