Atrial Fibrillation After Coronary Artery Bypass Surgery: Risk Factors, Prevention and Treatment

Petrakova, E S; Savina, N M; Молочков, А В

doi:10.18087/cardio.2020.9.n1074

Cited by 9 publications

(9 citation statements)

References 103 publications

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“…В нашем исследовании не получено данных о взаимосвязи пФП после КШ с возрастом пациентов, исходной ХБП, СД, функциональным классом ХСН, длительностью операции и искусственного кровообращения и другими факторами, хотя в литературе такие данные имеются [1,2,5].…”

Section: материал и методыunclassified

“…Наиболее частые осложнения коронарного шунтирования (КШ) в раннем послеоперационном периоде -пароксизмы фибрилляции предсердий (ФП) и острое повреждение почек (ОПП) [1,2]. И ОПП, и пароксизмы ФП существенно повышают риск развития послеоперационных осложнений, госпитальной и отдаленной смертности [3,4].…”

Section: Introductionunclassified

“…И ОПП, и пароксизмы ФП существенно повышают риск развития послеоперационных осложнений, госпитальной и отдаленной смертности [3,4]. Послеоперационное ОПП и пароксизмы ФП имеют некоторые общие факторы риска развития, среди которых -пожилой возраст, артериальная гипертония (АГ), сахарный диабет (СД) 2 типа, хроническая болезнь почек (ХБП), хроническая сердечная недостаточность (ХСН) и другие [1]. В ранее проведенных работах показано, что к развитию пароксизмов ФП после КШ предрасполагает не только ХБП, но также послеоперационное ОПП [2,5].…”

Section: Introductionunclassified

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Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors

Kremneva,

Arutyunyan,

Gapon

et al. 2023

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To identify predictors of paroxysmal atrial fibrillation (pAF) in patients with stable angina after coronary artery bypass grafting (CABG), as well as to evaluate the effect of sodium-glucose cotransporter 2 (SGLT-2) inhibitors.Material and methods. We examined 92 patients with stable angina who received CABG, aged 64±7 years (men, 78,3%). Among this cohort, 81,5% of patients had multivessel coronary artery disease, carbohydrate metabolism disorders — 35,6%, hypertension — 96,7%, chronic kidney disease (CKD) — 23,9%, preprocedural pAF — 10,9%, previous myocardial infarction (MI) — 54,3%. Off-pump CABG was performed in 31,5%, including bilateral inthernal thoracic artery grafting — in 50%. Cardiopulmonary bypass time was 68 (55-83) minutes. The number of grafts was 2,7±0,7. In addition, 18,5% of individuals received SGLT-2 inhibitors. Serum creatinine content was determined by the Jaffe method, and CKD was diagnosed with glomerular filtration rate <60 ml/min. Acute kidney injury (AKI) was assessed according to the KDIGO criteria (2012).Results. The number of patients who had pAF after CABG was 29,3%, AKI — 16,3%. There were following parameters associated with pAF after CABG: creatinine (100;82-142 in patients with pAF and 83;69-105 μmol/l — without pAF, p=0,032) and urea (7,8;5,8-9,7 in patients with pAF and 5,9;4,7-9,1 mmol/l — without pAF, p=0,025) one day after the intervention; postoperative AKI was revealed in 33,3% and 9,2% (p=0,004), while the number of patients taking SGLT-2 inhibitors was 3,7% and 24,6% (p=0,019) in those with and without pAF, respectively. The probability of pAF after CABG increased by an average of 5,5 times with AKI. Patients with pAF after CABG compared to patients without pAF have a higher rate of AKI, intraoperative MI, and cardiac death.Conclusion. The number of patients with pAF after CABG was 29,3%, AKI — 16,3%. Post-CABG pAF predictor was postoperative AKI. The use of SGLT-2 inhibitors was associated with a lower incidence of pAF after intervention. Patients with pAF after CABG have a poor inhospital prognosis.

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Section: материал и методыunclassified

Section: Introductionunclassified

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Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors

Kremneva,

Arutyunyan,

Gapon

et al. 2023

Racionalʹnaâ farmakoterapiâ v kardiologii

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“…послеоперационного периода. Послеоперационная ФП (ПОФП) способствует удлинению госпитального периода, повышает раннюю и отсроченную послеоперационную летальность ввиду развития расстройств центральной и системной гемодинамики, а также нарушений мозгового кровообращения кардиоэмболической этиологии [1].…”

Section: ключевые моменты что известно о предмете исследования?unclassified

“…Inflammatory continuum in the pathogenesis of atrial fibrillation after coronary bypass surgery Mingalimova A. R. 1,2 , Drapkina O. M. 1 , Sagirov M. A. 2 , Mazanov M. Kh.…”

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confidence: 99%

Inflammatory continuum in the pathogenesis of atrial fibrillation after coronary bypass surgery

Mingalimova

Drapkina²,

Sagirov

et al. 2022

Cardiovasc Ther Prev

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Atrial fibrillation (AF) after coronary bypass surgery is recorded in 20- 60% of patients and increase the early and long-term postoperative mortality. The aim of the review is to analyze the studies on causal relationships between damaging factors and the development of myocardial inflammation at each stage of surgical treatment in patients with multivessel coronary artery disease. In the review, myocardial inflammation is considered from the point of view of a continuum — a chronic process that originates from the coronary endothelium damage and continuously proceeds within the AF pathogenesis after coronary bypass surgery. For the first time, the concept of inflammatory continuum for postoperative AF is introduced. The review discusses the main and latest laboratory and instrumental markers of local and systemic inflammatory response, which are informative in terms of severity and promising for improving approaches to the diagnosis and prevention of postoperative AF. The review was prepared using available materials from Russian and foreign library databases (PubMed, Medline, Web of Science and Cochrane Library). The search depth was >25 years since 1996. Based on the analysis of available studies, we concluded that inflammation is not just evidence of AF, but plays a causal role in its pathogenesis at each stage of surgical myocardial revascularization.

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Evaluation of left atrial strain using speckle-tracking echocardiography to predict postoperative atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis

Golukhova,

Bulaeva,

Mrikaev

et al. 2023

Russ J Cardiol

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Aim. To conduct a systematic review and meta-analysis to investigate the prognostic role of left atrial (LA) strain assessment using speckle-tracking echocardiography to predict postoperative atrial fibrillation (POAF) in patients undergoing coronary bypass grafting (CABG).Material and methods. We searched the PubMed (Medline) and Google Scholar databases for studies investigating LA strain measures obtained by speckle tracking echocardiography as predictors of POAF in patients after CABG. To determine the difference in the weighted average LA strain parameters, an analysis was made of the global LA strain, peak atrial longitudinal strain (PALS), left atrial conduit strain (LACS) and left atrial contractile strain (LACtS). Odds ratio (OR) values were received from multivariate models reporting association between PALS and POAF and described as pooled estimates with 95% confidence intervals (CI).Results. Twelve studies from 404 publications were selected for this systematic review and meta-analysis. A total of 1093 patients were included in the analysis, with a mean age of 60,5 years. A meta-analysis showed that patients with POAF had lower global LA strain than patients without POAF (difference in weighted values, 5,03%; 95% CI: -6,89 to -3,16; p<0,001). In addition, patients with POAF had lower PALS, LACS and LACtS; the difference in weighted values was 9,90% (95% CI: -12,95 to -6,85; p<0,001), 4,17% (95% CI: -6,05 to -2,29; p<0,001) and 6,1 7% (95% CI: -12,01 to -0,33; p=0,04), respectively. Moreover, in a pooled odds ratio (OR) analysis, PALS was found to be an independent predictor of POAF (OR: 0,88 for every 1% increase in PALS; 95% CI: 0,82–0,94; p<0,0001).Conclusion. Assessment of LA strain using speckle-tracking echocardiography provides important additional information for predicting POAF in patients undergoing isolated CABG.

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Atrial Fibrillation After Coronary Artery Bypass Surgery: Risk Factors, Prevention and Treatment

Cited by 9 publications

References 103 publications

Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors

Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors

Inflammatory continuum in the pathogenesis of atrial fibrillation after coronary bypass surgery

Evaluation of left atrial strain using speckle-tracking echocardiography to predict postoperative atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis

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