Effect of Preoperative Obstructive Sleep Apnea on the Frequency of Atrial Fibrillation After Coronary Artery Bypass Grafting
Patients with obstructive sleep apnea (OSA) have intermittent hypoxia leading to atrial remodeling and this has been associated with the development of atrial fibrillation (AF). Postoperative AF is a common complication of coronary artery bypass grafting (CABG). The aim of this prospective study was...
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| Veröffentlicht in: | The American journal of cardiology 2014-03, Vol.113 (6), p.919-923 |
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| creator | van Oosten, Erik M., MD, MSc Hamilton, Andrew, MD Petsikas, Dimitri, MD Payne, Darrin, MD Redfearn, Damian P., MBChB Zhang, Shetuan, PhD Hopman, Wilma M., MA Baranchuk, Adrian, MD |
| description | Patients with obstructive sleep apnea (OSA) have intermittent hypoxia leading to atrial remodeling and this has been associated with the development of atrial fibrillation (AF). Postoperative AF is a common complication of coronary artery bypass grafting (CABG). The aim of this prospective study was to determine whether the presence of OSA predicts the occurrence of post-CABG AF (PCAF). This was a prospective single-center study. Patients undergoing elective CABG were evaluated and categorized as confirmed, high-risk, or low-risk OSA according to a modified Berlin questionnaire. PCAF was evaluated by 24-hour cardiac monitoring strip or 12-lead electrocardiography during the postoperative period, and validated by an electrophysiologist. We included 277 patients. OSA prevalence was 47.7%, with body mass index (31.0 vs 26.9 kg/m2 , p ≤0.001), advanced age (63.7 vs 66.4 years, p = 0.031), hypertension (78.0% vs 64.8%, p = 0.015), and diabetes (45.5% vs 28.3%, p = 0.003) more prevalent in the OSA group. PCAF was found to occur in 37.2% of all patients and OSA was found to be a strong predictor of PCAF (45.5% vs 29.7%, p = 0.007). PCAF was also associated with continuous positive airway pressure use (12.6% vs 5.2%, p = 0.027). Increased length of stay was associated with PCAF (6.5 vs 5.3 days, p = 0.006), as was longer time from surgery to occurrence of PCAF (p = 0.001). In conclusion, OSA was found to be a strong predictor of PCAF, which in turn was found to be associated with increased length of stay. |
| doi_str_mv | 10.1016/j.amjcard.2013.11.047 |
| format | Article |
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Postoperative AF is a common complication of coronary artery bypass grafting (CABG). The aim of this prospective study was to determine whether the presence of OSA predicts the occurrence of post-CABG AF (PCAF). This was a prospective single-center study. Patients undergoing elective CABG were evaluated and categorized as confirmed, high-risk, or low-risk OSA according to a modified Berlin questionnaire. PCAF was evaluated by 24-hour cardiac monitoring strip or 12-lead electrocardiography during the postoperative period, and validated by an electrophysiologist. We included 277 patients. OSA prevalence was 47.7%, with body mass index (31.0 vs 26.9 kg/m2 , p ≤0.001), advanced age (63.7 vs 66.4 years, p = 0.031), hypertension (78.0% vs 64.8%, p = 0.015), and diabetes (45.5% vs 28.3%, p = 0.003) more prevalent in the OSA group. PCAF was found to occur in 37.2% of all patients and OSA was found to be a strong predictor of PCAF (45.5% vs 29.7%, p = 0.007). PCAF was also associated with continuous positive airway pressure use (12.6% vs 5.2%, p = 0.027). Increased length of stay was associated with PCAF (6.5 vs 5.3 days, p = 0.006), as was longer time from surgery to occurrence of PCAF (p = 0.001). In conclusion, OSA was found to be a strong predictor of PCAF, which in turn was found to be associated with increased length of stay.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2013.11.047</identifier><identifier>PMID: 24462068</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Asthma ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - etiology ; Atrial Fibrillation - physiopathology ; Body mass index ; Cardiac arrhythmia ; Cardiovascular ; Cardiovascular disease ; Confidence intervals ; Coronary Artery Bypass - adverse effects ; Coronary Artery Disease - mortality ; Coronary Artery Disease - surgery ; Coronary vessels ; Electrocardiography ; Female ; Follow-Up Studies ; Heart surgery ; Hospitals ; Humans ; Hypertension ; Incidence ; Logistics ; Male ; Middle Aged ; Ontario - epidemiology ; Patients ; Postoperative Complications ; Preoperative Period ; Prevalence ; Prognosis ; Prospective Studies ; Risk Factors ; Sleep ; Sleep apnea ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - epidemiology ; Surgical outcomes ; Survival Rate - trends ; Variables ; Variance analysis</subject><ispartof>The American journal of cardiology, 2014-03, Vol.113 (6), p.919-923</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Mar 15, 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-b00c1349ba0dff3aeecbc6521832da2d760971e081ebca0e7e6179737c0aa1753</citedby><cites>FETCH-LOGICAL-c514t-b00c1349ba0dff3aeecbc6521832da2d760971e081ebca0e7e6179737c0aa1753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914913024466$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24462068$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Oosten, Erik M., MD, MSc</creatorcontrib><creatorcontrib>Hamilton, Andrew, MD</creatorcontrib><creatorcontrib>Petsikas, Dimitri, MD</creatorcontrib><creatorcontrib>Payne, Darrin, MD</creatorcontrib><creatorcontrib>Redfearn, Damian P., MBChB</creatorcontrib><creatorcontrib>Zhang, Shetuan, PhD</creatorcontrib><creatorcontrib>Hopman, Wilma M., MA</creatorcontrib><creatorcontrib>Baranchuk, Adrian, MD</creatorcontrib><title>Effect of Preoperative Obstructive Sleep Apnea on the Frequency of Atrial Fibrillation After Coronary Artery Bypass Grafting</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Patients with obstructive sleep apnea (OSA) have intermittent hypoxia leading to atrial remodeling and this has been associated with the development of atrial fibrillation (AF). Postoperative AF is a common complication of coronary artery bypass grafting (CABG). The aim of this prospective study was to determine whether the presence of OSA predicts the occurrence of post-CABG AF (PCAF). This was a prospective single-center study. Patients undergoing elective CABG were evaluated and categorized as confirmed, high-risk, or low-risk OSA according to a modified Berlin questionnaire. PCAF was evaluated by 24-hour cardiac monitoring strip or 12-lead electrocardiography during the postoperative period, and validated by an electrophysiologist. We included 277 patients. OSA prevalence was 47.7%, with body mass index (31.0 vs 26.9 kg/m2 , p ≤0.001), advanced age (63.7 vs 66.4 years, p = 0.031), hypertension (78.0% vs 64.8%, p = 0.015), and diabetes (45.5% vs 28.3%, p = 0.003) more prevalent in the OSA group. PCAF was found to occur in 37.2% of all patients and OSA was found to be a strong predictor of PCAF (45.5% vs 29.7%, p = 0.007). PCAF was also associated with continuous positive airway pressure use (12.6% vs 5.2%, p = 0.027). Increased length of stay was associated with PCAF (6.5 vs 5.3 days, p = 0.006), as was longer time from surgery to occurrence of PCAF (p = 0.001). In conclusion, OSA was found to be a strong predictor of PCAF, which in turn was found to be associated with increased length of stay.</description><subject>Aged</subject><subject>Asthma</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - etiology</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Body mass index</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Confidence intervals</subject><subject>Coronary Artery Bypass - adverse effects</subject><subject>Coronary Artery Disease - mortality</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary vessels</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart surgery</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Incidence</subject><subject>Logistics</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Ontario - epidemiology</subject><subject>Patients</subject><subject>Postoperative Complications</subject><subject>Preoperative Period</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sleep</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - epidemiology</subject><subject>Surgical outcomes</subject><subject>Survival Rate - trends</subject><subject>Variables</subject><subject>Variance analysis</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk9v1DAQxS0EotvCRwBZ4sIlYSb_vLmAwqrbIlUqUuFsOc4EHLJxsJNKkfjwON0FpF442ZZ-b_xm3jD2CiFGwOJdF6tDp5Vr4gQwjRFjyMQTtsGtKCMsMX3KNgCQRCVm5Rk7974LT8S8eM7OkiwrEii2G_brsm1JT9y2_LMjO5JTk7knflv7yc364X7XE428GgdS3A58-k587-jnTINeVmE1OaN6vje1M30f9AGq2okc31lnB-UWXrnwXPjHZVTe8yun2skM316wZ63qPb08nRfs6_7yy-46urm9-rSrbiKdYzZFNYDGNCtrBU3bpopI17rIE9ymSaOSRhRQCiTYItVaAQkqUJQiFRqUQpGnF-ztse7obLDtJ3kwXlPwOpCdvcQcMswCmAX0zSO0s7MbgrtAJXkptgEMVH6ktLPeO2rl6MwhNCoR5BqP7OQpHrnGIxElPOhen6rP9YGav6o_eQTgwxGgMI57Q056bcKcqTEuxCQba_77xftHFXRvBqNV_4MW8v-6kT6RIO_WHVlXBFNYXRTpbwapuLg</recordid><startdate>20140315</startdate><enddate>20140315</enddate><creator>van Oosten, Erik M., MD, MSc</creator><creator>Hamilton, Andrew, MD</creator><creator>Petsikas, Dimitri, MD</creator><creator>Payne, Darrin, MD</creator><creator>Redfearn, Damian P., MBChB</creator><creator>Zhang, Shetuan, PhD</creator><creator>Hopman, Wilma M., MA</creator><creator>Baranchuk, Adrian, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20140315</creationdate><title>Effect of Preoperative Obstructive Sleep Apnea on the Frequency of Atrial Fibrillation After Coronary Artery Bypass Grafting</title><author>van Oosten, Erik M., MD, MSc ; Hamilton, Andrew, MD ; Petsikas, Dimitri, MD ; Payne, Darrin, MD ; Redfearn, Damian P., MBChB ; Zhang, Shetuan, PhD ; Hopman, Wilma M., MA ; Baranchuk, Adrian, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-b00c1349ba0dff3aeecbc6521832da2d760971e081ebca0e7e6179737c0aa1753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Asthma</topic><topic>Atrial Fibrillation - 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Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Oosten, Erik M., MD, MSc</au><au>Hamilton, Andrew, MD</au><au>Petsikas, Dimitri, MD</au><au>Payne, Darrin, MD</au><au>Redfearn, Damian P., MBChB</au><au>Zhang, Shetuan, PhD</au><au>Hopman, Wilma M., MA</au><au>Baranchuk, Adrian, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Preoperative Obstructive Sleep Apnea on the Frequency of Atrial Fibrillation After Coronary Artery Bypass Grafting</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2014-03-15</date><risdate>2014</risdate><volume>113</volume><issue>6</issue><spage>919</spage><epage>923</epage><pages>919-923</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Patients with obstructive sleep apnea (OSA) have intermittent hypoxia leading to atrial remodeling and this has been associated with the development of atrial fibrillation (AF). Postoperative AF is a common complication of coronary artery bypass grafting (CABG). The aim of this prospective study was to determine whether the presence of OSA predicts the occurrence of post-CABG AF (PCAF). This was a prospective single-center study. Patients undergoing elective CABG were evaluated and categorized as confirmed, high-risk, or low-risk OSA according to a modified Berlin questionnaire. PCAF was evaluated by 24-hour cardiac monitoring strip or 12-lead electrocardiography during the postoperative period, and validated by an electrophysiologist. We included 277 patients. OSA prevalence was 47.7%, with body mass index (31.0 vs 26.9 kg/m2 , p ≤0.001), advanced age (63.7 vs 66.4 years, p = 0.031), hypertension (78.0% vs 64.8%, p = 0.015), and diabetes (45.5% vs 28.3%, p = 0.003) more prevalent in the OSA group. PCAF was found to occur in 37.2% of all patients and OSA was found to be a strong predictor of PCAF (45.5% vs 29.7%, p = 0.007). PCAF was also associated with continuous positive airway pressure use (12.6% vs 5.2%, p = 0.027). Increased length of stay was associated with PCAF (6.5 vs 5.3 days, p = 0.006), as was longer time from surgery to occurrence of PCAF (p = 0.001). In conclusion, OSA was found to be a strong predictor of PCAF, which in turn was found to be associated with increased length of stay.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24462068</pmid><doi>10.1016/j.amjcard.2013.11.047</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Asthma Atrial Fibrillation - epidemiology Atrial Fibrillation - etiology Atrial Fibrillation - physiopathology Body mass index Cardiac arrhythmia Cardiovascular Cardiovascular disease Confidence intervals Coronary Artery Bypass - adverse effects Coronary Artery Disease - mortality Coronary Artery Disease - surgery Coronary vessels Electrocardiography Female Follow-Up Studies Heart surgery Hospitals Humans Hypertension Incidence Logistics Male Middle Aged Ontario - epidemiology Patients Postoperative Complications Preoperative Period Prevalence Prognosis Prospective Studies Risk Factors Sleep Sleep apnea Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - epidemiology Surgical outcomes Survival Rate - trends Variables Variance analysis |
| title | Effect of Preoperative Obstructive Sleep Apnea on the Frequency of Atrial Fibrillation After Coronary Artery Bypass Grafting |
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