Postoperative hyperglycemia and atrial fibrillation after coronary artery bypass graft surgery

Circ J. 2015;79(1):112-8. doi: 10.1253/circj.CJ-14-0989. Epub 2014 Nov 12.

Abstract

Background: Postoperative atrial fibrillation (AF) is a common complication following coronary artery bypass grafting (CABG). We investigated the risk factors for postoperative AF and analyzed the relationship between blood sugar concentration (BS) and AF after CABG.

Methods and results: A total of 199 consecutive patients who underwent isolated CABG were retrospectively examined and classified according to the presence (n=95) or absence (n=104) of postoperative AF. On univariate analysis mean postoperative BS (P<0.001), postoperative drainage volume (P<0.001), age (P=0.034), presence of diabetes mellitus (DM; P=0.004), and postoperative estimated glomerular filtration rate (P=0.032) were significant risk factors for postoperative AF. On multivariate analysis mean postoperative BS (OR, 1.041; 95% CI: 1.008-1.079; P<0.001), postoperative drainage volume (OR, 1.003; 95% CI: 1.001-1.006; P=0.001), and age (OR, 1.040; 95% CI: 1.002-1.083; P=0.041) were significant risk factors for postoperative AF. Postoperative AF often occurred in patients with high postoperative BS, irrespective of DM. The BS cut-off that predicted postoperative AF occurrence was 180 mg/dl. A strong positive correlation existed between the time of the maximum postoperative BS and AF onset time (ρ=0.746).

Conclusions: Mean postoperative BS and postoperative drainage volume are risk factors for AF after CABG. AF was strongly associated with maximum postoperative BS. Intensive glycemic control could reduce AF occurrence after CABG.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / blood
  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / etiology
  • Blood Glucose / analysis
  • Cardiovascular Agents / therapeutic use
  • Case-Control Studies
  • Cerebral Infarction / epidemiology
  • Comorbidity
  • Coronary Artery Bypass* / adverse effects
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / epidemiology*
  • Hyperglycemia / etiology
  • Male
  • Odds Ratio
  • Postoperative Complications / blood
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Factors

Substances

  • Blood Glucose
  • Cardiovascular Agents