ABSTRACT
Objective: To investigate the relationship between
aortic stiffness and postoperative
atrial fibrillation (POAF) in
patients undergoing
coronary artery bypass grafting (CABG).
Methods: This study included 110
patients undergoing elective isolated CABG.
Aortic stiffness was measured using a noninvasive oscillometric
sphygmomanometer before
surgery . Characteristics of
patients with and without POAF were compared.
Results: POAF developed in 32 (29.1%)
patients .
Patients with POAF were older (63.7±8.6 vs. 58.3±8.4; P=0.014).
Chronic obstructive pulmonary disease (
COPD ) was more common in
patients with POAF (11.5% vs. 37.5%; P=0.024), whereas the frequency of
hypertension ,
diabetes mellitus ,
smoking , and previous
coronary artery disease did not differ.
C-reactive protein and
cholesterol levels were
similar between
patients with and without POAF. Left atrial diameter was greater in
patients with POAF (35.9±1.6 vs. 36.7±1.7; P<0.039). Peripheral (p) and central (c) systolic and diastolic
blood pressures were also
similar between the groups, whereas both p and c
pulse pressures (PP) were greater in
patients with POAF (pPP 44.3±11.9 vs. 50.3±11.6; P=0.018, cPP 31.4±8.1 vs. 36.2±8.9; P=0.008).
Pulse wave velocity (PWV) was significantly higher in POAF (8.6+1.3 vs. 9.4+1.3; P=0.006). PWV, pPR and
COPD were independent predictors of POAF in multivariate
regression analysis . In
receiver operating characteristic analysis , PWV and pPP have
similar accuracy for predicting POAF (PWV, area under the curve [
AUC ] 0.661, 95%
confidence interval [CI] [0.547-0.775], P=0.009) (pPP,
AUC 0.656, 95% CI [0.542-0.769], P=0.012).
Conclusion: COPD , PWV, and PP are predictors of POAF. PP and PWV, easily measured in office conditions, might be useful for detecting
patients with a higher
risk of POAF.