Objective
Postoperative atrial fibrillation (POAF) is one of the most common complications of cardiac surgery and frequency varies according to the type of surgery. Prognostic nutritional index (PNI), has been shown to be associated with adverse outcomes in heart failure, stroke, chronic renal failure, coronary artery disease, and ST-segment elevation myocardial infarction. In this study, we aimed to evaluate the relationship between PNI and POAF development in patients with a diagnosis of chronic coronary syndrome who underwent coronary angiography and decided to have coronary artery bypass graft (CABG) operation.
Methods
Patients diagnosed with chronic coronary syndromes and decided to be treated by CABG surgery at our institution between March 2014 and 2019 were evaluated retrospectively.
Results
A total of 314 patients were included in the study. Two groups were formed according to POAF development. 58 patients constituted the POAF (+) and 256 patients formed the POAF (-) group. Age, body mass index (BMI), hypertension, coronary artery disease, chronic obstructive pulmonary disease, creatinine values were statistically significantly higher and hemoglobin, hematocrit, left ventricular ejection fraction (LVEF) and PNI were found lower in the POAF (+) group. Advanced age, high BMI and creatinine, low LVEF and PNI were determined as independent risk factors for the development of POAF. It was concluded that a cut-off value of 53.13 for PNI could predict the development of POAF with 70.9% sensitivity and 69.6% specificity.
Conclusion
POAF was observed more frequently in patients in lower PNI values. PNI is an easy to use, rapidly measured and widely available index and have good diagnostic accuracy in determining POAF development. Aggressive treatment of malnutrition will be important in addition to personalized dyslipidemia therapy in patients with stable coronary artery disease.
Key words: Prognostic nutritional index; postoperative atrial fibrillation; coronary artery bypass graft surgery.
|
