Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri
Yıl: 2020 Cilt: 26 Sayı: 2 Sayfa Aralığı: 71 - 79 Metin Dili: Türkçe DOI: 10.5222/GKDAD.2020.41033 İndeks Tarihi: 27-11-2020
Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri
Öz: Amaç: Koroner arter baypas greft (KABG) cerrahisi sonrası görülen en sık ritm bozukluğu olanAtriyal Fibrilasyonda (AF) risk faktörlerini belirlemek ve C-Reaktif Protein (CRP) ile AF arasında birkorelasyon olup olmadığını göstermektir.Yöntem: Koroner arter cerrahisi yapılacak 250 hasta prospektif olarak çalışmaya alındı. Tümhastaların demografik verileri, peroperatif ve postoperatif değişkenleri ve postoperatif 6.günedek günlük CRP ve AF takipleri ile, AF olanların tedavi protokolleri kaydedildi.Bulgular: Takip edilen hastaların 43’ünde (%17,2) AF tespit edildi. Multivariate analizde, ileri yaş,hipertansiyon (HT) ve preoperatif kalsiyum kanal blokeri kullanma ile AF arasında anlamlı birilişki olduğu saptandı (p<0.05). CRP değerleri postoperatif 2. günde en yüksek değere ulaştı. AFbu dönemde 14 hastada görülmüş (%5.6) olmakla birlikte, CRP yüksekliği ile AF gelişimi arasındabir ilişki tespit edilemedi (p>0.05). AF gelişen hastaların yoğun bakım ve hastanede kalış sürelerinin istatistiksel olarak anlamlı uzun olduğu gözlendi (p<0.05).Sonuç: ABG operasyonu geçiren ileri yaştaki, hipertansif, preoperatif kalsiyum kanal blokeri kullanan hastalarda, AF gelişme riskinin daha fazla olduğu ve AF tespit edilen hastaların yoğun bakımve hastanede kalış sürelerinin daha uzun olduğu tespit edilmiş ve AF ile CRP arasında bir korelasyon bulunamamıştır.
Anahtar Kelime: Atrial Fibrillation After Coronary Artery Bypass Surgery: Risk Factors
Öz: Objective: The aim of this study was to determine the risk factors in atrial fibrillation (AF), which is the most common rhythm disorder observed after coronary artery bypass graft (CABG) surgery, and to show whether there is a correlation between C-reactive protein (CRP) and AF. Methods: A total of 250 patients who would undergo coronary artery surgery were retrospectively included in the study. Demographic data, peroperative and postoperative variables of all patients, daily CRP and AF follow-ups until the 6th postoperative day and treatment protocols of AF patients were recorded. Results: AF was detected in 43 (17.2%) of the patients who were followed up. It was found that there was a statistically significant relationship in the multivariate analysis between advanced age, hypertension (HT) and use of preoperative calcium channel blocker and AF (p<0.05). CRP values reached the highest value on the 2nd postoperative day. Although AF was seen in 14 patients (5.6%) in this period, no relation was found between increased CRP levels and the development of AF (p>0.05). It was observed that the length of intensive care and hospital stay of patients with AF was statistically significantly longer (p<0.05). Conclusion: It was found that older hypertensive patients who preoperatively used calcium channel blocker had a higher risk of developing AF. Duration of ICU and hospital stay was longer, and no correlation was found between AF and CRP
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Adalet K. Atriyal fibrilasyonun güncel farmakolojik tedevasi. Türk kardiyol Dern Arş 2002;30:104-18 .
- 2. Marso SP, Griffin BP, Topol EJ. Manual of cardiovascular medicine. Phiadephia: Lippincott Williams & Wilkins;2000.
- 3. Mashat AA, Subki AH, Bakhaider MA. Atrial fibrillation: risk factors and comorbidities in a tertiary center in Jeddah, Saudi Arabia. Int J Gen Med. 2019 Jan 11;12:71- 77. https://doi.org/10.2147/IJGM.S188524
- 4. Creswell LL, Damiano RJ. Postoperative atrial fibrillation: an old problem crying for new solutions. J Thorac Cardiovasc Surg. 2001; 121: 638 - 641. https://doi.org/10.1067/mtc.2001.114347
- 5. Steinberg BA, Zhao Y, He X, Hernandez AF, Fullerton DA, Thomas K, et al. Management of postoperative atrial fibrillation and subsequent outcomes in contemporary patients undergoing cardiac surgery: insights from the Society of Thoracic Surgeons CAPS-Care Atrial Fibrillation Registry. Clin Cardiol. 2014;37:7-13. https://doi.org/10.1002/clc.22230
- 6. Tinica G, Mocanu V, Zugun-Eloae F and Butcovan D. Clinical and histological predictive risk factors of atrial fibrillation in patients undergoing open-heart surgery Exp Ther Med. 2015 Dec;10(6):2299-304. https://doi.org/10.3892/etm.2015.2790
- 7. Engelman MD, Svendsen JH. Inflammation in the genesis and perpetuation of atrial fibrillation. Eur Heart J 2005;26:2083-92. https://doi.org/10.1093/eurheartj/ehi350
- 8. Boos CJ, Anderson RA, Lip GY. Is atrial fibrillation an inflammatory disorder? Eur Heart J 2006;27:136-49. https://doi.org/10.1093/eurheartj/ehi645
- 9. Ehrlich JR, Hohnloser SH, Nattel S. Role of angiotensin system and effects of its inhibition in atrial fibrillation: clinical and experimental evidence. Eur Heart J 2006;27:512-8. https://doi.org/10.1093/eurheartj/ehi668
- 10. Brasier AR, Recinos A, Eledrisi MS. Vascular inflammation and the renin angiotensin system. Arterioscler Thromb Vasc Biol 2002;22:1257-66. https://doi.org/10.1161/01.ATV.0000021412.56621.A2
- 11. Chung MK, Martin DO, Sprecher D, Wazni O, Kanderian A, Canes CA, Bauer JA, et al. C- reactive protein elevation in patientd with atrial arythmias; inflammatory mechanisms and persistance of atrial fibrillation. Circulation 2001;104:2886-91. https://doi.org/10.1161/hc4901.101760
- 12. Manfrini O, Cenko E, Ricci B, Bugiardini R. Post cardiovascular surgery atrial fibrillation. Biomarkers Determining Prognosis. Curr Med Chem. 2019;26(5): 916-24. https://doi.org/10.2174/0929867324666170727104930
- 13. Chung MK. Cardiac surgery: potoperative arrhythmias. Crit Care Med 2000;28(10 Suppl): N136-44. https://doi.org/10.1097/00003246-200010001-00005
- 14. Houge CW Jr, Creswell LL, Gutterman DD, Fleisher LA; American College of Chest Physicians. Epidemiology, mechanisms and risks: American College of Chest Physicians guidelines fort he prevention andmanagement of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128:9-16. https://doi.org/10.1378/chest.128.2_suppl.9S
- 15. Farouk Musa A, Quan CZ, Xin LZ. A retrospective study on atrial fibrillation after coronary artery bypass grafting surgery at The National Heart Institute, Kuala Lumpur. Version 2. F1000Res. 2018 Feb 8;7:164. https://doi.org/10.12688/f1000research.13244.2
- 16. Hogue CW Jr, Hyder ML,. Atrial fibrillation after cardiac operation: Risks, mechanism and treatment. Ann Thorac Surg 2000;69:300-6.
- 17. Maisel WH, Rawn JD, Stevenson WG. Atrial fibrillation after cardiac surgery. Ann Intern Med. 2001;135:1061- 73. https://doi.org/10.7326/0003-4819-135-12- 200112180-00010
- 18. Bessissow A, Khan J, Devereaux PJ, Alvarez-Garcia J, Alonso-Coello P. Postoperative atrial fibrillation in noncardiac and cardiac surgery: an overview. J Thromb Haemost. 2015 Jun;13 Suppl 1:S304-12. https://doi.org/10.1111/jth.12974
- 19. Frost L, Hune LJ, Vestergaard P. Overweight and obesity as risk factors for atrial fibrilation or flutter: the Danish Diet, Cancer, and Health Study. Am J Med. 2005;118:489- 95.
- 20. Ekim H, Kutay V, Demirbağ R, Turan E, Hazar A, Karadağ M. Koroner arter cerrahisi sonrası atrial fibrilasyon gelişiminde rol oynayan faktörler. Van Tıp Dergisi: 11 (2):43-47, 2004.
- 21. Funk M, Richards SB, Desjardins J, Bebon C. Incidince, timing, symptoms, and risk factors for atrial fibrillation after cardiac surgery. Am J Crit Care 2003;12:424-45. https://doi.org/10.4037/ajcc2003.12.5.424
- 22. Filardo G, Ailawadi G, Pollock BD. Postoperative atrial fibrillation: Sex-specific characteristics and effect on survival. J Thorac Cardiovasc Surg. 2020 Apr;159(4): 1419-25. https://doi.org/10.1016/j.jtcvs.2019.04.097
- 23. Giuseppe Patti, Massimo Chello, Dario candura, et al. Randomized Trial of Atorvastatin for Reduction of Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery (ARMYDA-3). Circulation. 2006;114: 1455-61. https://doi.org/10.1161/CIRCULATIONAHA.106.621763
- 24. Crystal E, Connolly SJ, Sleik K, et al. Interventions on prevention of postoperative atrial fibrillation in patients undergoing heart surgery: a meta-analysis. Circulation 2002;106:75-80. https://doi.org/10.1161/01.CIR.0000021113.44111.3E
- 25. Gudbjartsson T, Helgadottir S, Sigurdsson MI. Newonset postoperative atrial fibrillation after heart surgery. Acta Anaesthesiol Scand. 2020 Feb;64(2):145- 55. https://doi.org/10.1111/aas.13507
- 26. Siu CW, Lau CP, Tse HF. Prevention of atrial fibrillation a diversion. Am J Cardiol. 2003;92:1343-45. https://doi.org/10.1016/j.amjcard.2003.08.023
- 27. Nattel S, New ideas about atrial fibrillation 50 years on. Nature 2002;415:219-26. https://doi.org/10.1038/415219a
- 28. Healey JS, Baranchuk A, Crystal E, et al. Prevention of atrial fibrillation with anjiotensin converting enzyme inhibitors and anjiotensin receptor blockers: a metaanalysis. J Am Coll Cardiol. 2005;45:1832-9. https://doi.org/10.1016/j.jacc.2004.11.070
- 29. Weymann A, Popov AF, Sabashnikov A, et al. Baseline and postoperative levels of C-reactive protein and interleukins as inflammatory predictors of atrial fibrillation following cardiac surgery: a systematic review and meta-analysis. Kardiol Pol. 2018;76(2):440-51. https://doi.org/10.5603/KP.a2017.0242
- 30. Sony Jacob , Omaima A Ali, Victoria Pidlaoan, Apurva O Badheka, Nicholas Z Kerin. Pharmacotherapy of Atrial Fibrillation: A Pathophysiological Perspective and Review. Am J Ther 2011 May;18(3):241-60 https://doi.org/10.1097/MJT.0b013e3181eea7c5
- 31. Baeza-Herrera LA, Rojas-Velasco G, Márquez-Murillo MF. Atrial fibrillation in cardiac surgery. Arch Cardiol Mex. 2019;89(4):348-59. https://doi.org/10.24875/ACME.M20000068
- 32. Atılgan K, Demirdaş E, Günay C. Koroner arter cerrahisi sonrası görülen atriyal fibrilasyon gelişimine etki eden faktörler Bozok Tıp Derg. 2017;7(4):29-35.
| APA | yurtseven n, Savaskan D, karakaş o (2020). Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri. , 71 - 79. 10.5222/GKDAD.2020.41033 |
| Chicago | yurtseven nurgul,Savaskan Dilek,karakaş oya Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri. (2020): 71 - 79. 10.5222/GKDAD.2020.41033 |
| MLA | yurtseven nurgul,Savaskan Dilek,karakaş oya Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri. , 2020, ss.71 - 79. 10.5222/GKDAD.2020.41033 |
| AMA | yurtseven n,Savaskan D,karakaş o Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri. . 2020; 71 - 79. 10.5222/GKDAD.2020.41033 |
| Vancouver | yurtseven n,Savaskan D,karakaş o Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri. . 2020; 71 - 79. 10.5222/GKDAD.2020.41033 |
| IEEE | yurtseven n,Savaskan D,karakaş o "Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri." , ss.71 - 79, 2020. 10.5222/GKDAD.2020.41033 |
| ISNAD | yurtseven, nurgul vd. "Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri". (2020), 71-79. https://doi.org/10.5222/GKDAD.2020.41033 |
| APA | yurtseven n, Savaskan D, karakaş o (2020). Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, 26(2), 71 - 79. 10.5222/GKDAD.2020.41033 |
| Chicago | yurtseven nurgul,Savaskan Dilek,karakaş oya Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi 26, no.2 (2020): 71 - 79. 10.5222/GKDAD.2020.41033 |
| MLA | yurtseven nurgul,Savaskan Dilek,karakaş oya Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, vol.26, no.2, 2020, ss.71 - 79. 10.5222/GKDAD.2020.41033 |
| AMA | yurtseven n,Savaskan D,karakaş o Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi. 2020; 26(2): 71 - 79. 10.5222/GKDAD.2020.41033 |
| Vancouver | yurtseven n,Savaskan D,karakaş o Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi. 2020; 26(2): 71 - 79. 10.5222/GKDAD.2020.41033 |
| IEEE | yurtseven n,Savaskan D,karakaş o "Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri." Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, 26, ss.71 - 79, 2020. 10.5222/GKDAD.2020.41033 |
| ISNAD | yurtseven, nurgul vd. "Koroner Arter Baypas Cerrahisi Sonrası Atriyal Fibrilasyon: Risk Faktörleri". Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi 26/2 (2020), 71-79. https://doi.org/10.5222/GKDAD.2020.41033 |
