Gensini score predicts postoperative atrial fibrillation following on-pump coronary artery bypass grafting

Öz

Aim:  Postoperative atrial fibrillation (POAF) is common after coronary artery by-pass grafting surgery (CABG) and associated with adverse events. GENSINI score is a widely-used scoring system that quantifies angiographic atherosclerosis. The value of GENSINI score to predict POAF has not been studied previously. Aim of this study was to evaluate this relationship in our patients undergoing on-pump CABG surgery.

Material and Methods: In this retrospective, single-center study, a total of 113 patients without exclusion criteria were included. Demographic and clinical characteristics of patients were recorded and GENSINI scores were calculated. Univariate and multivariate logistic regression analyses were performed to identify the independent predictors of POAF.

Results: Postoperative atrial fibrillation developed in 34 (30%) patients. Multivariate logistic regression analyses revealed that C-Reactive Protein [ß=0.037, p=0.011, OR=1.03, 95% CI (1.008-1.065)] and GENSINI score [ß=0.015, p=0.024,OR=1.012, 95% CI (1.002-1.028)]  are independent predictors of POAF. The ROC analysis showed an area under the curve of 0.587 (p=0.012).  GENSINI score of > 50.75 had 82.4% sensitivity in predicting POAF [p=0.012, 95%CI (0.464-0.711)].

Conclusion: Our results showed that GENSINI score is an independent predictor of POAF in patients undergoing on-pump CABG surgery.

Anahtar Kelimeler

• Atrial fibrillation,coronary artery bypass grafting,gensini score

Gensini skoru pompa destekli koroner arter baypas greftleme sonrasi gelişen atriyal fibrilasyonun öngördürücüsüdür

Öz

Amaç: Postoperatif atriyal fibrilasyon (POAF), koroner arter baypas cerrahisi (CABG) sonrası sıktır ve istenmeyen olaylarla ilişkilidir. GENSINI skoru anjiyografik aterosklerozu derecelendirmek için yaygın olarak kullanılan bir skorlama sistemidir. POAF gelişiminin öngörülmesinde GENSINI skorunun rolü daha önce araştırılmamıştır.

Bu çalışmada pompa destekli CABG yapılan hastalarda POAF gelişiminin öngörülmesinde GENSINI skorunun rolünün değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Tek merkezde gerçekleştirilen bu retrospektif çalışmaya dışlama kriterleri olmayan 113 hasta dahil edildi. Demografik ve klinik özellikleri kaydedildi. GENSINI skorları hesaplandı. Postoperatif atriyal fibrilasyon gelişimi öngördürücülerini belirlemek amacıyla tek değişkenli ve çok değişkenli lojistik regresyon analizi yapıldı.

Bulgular: Hastaların %30’ unda POAF gelişti. Çok değişkenli lojistik regresyon analizinde C-Reaktif Protein [ß=0.037, p=0.011, OR=1.03, 95% CI (1.008-1.065)] ve GENSINI skorunun [ß=0.015, p=0.024,OR=1.012, 95% CI (1.002-1.028)]  Postoperatif atriyal fibrilasyon gelişiminin bağımsız öngördürücüleri olarak bulundu. Alıcı işletim karakteristiği (ROC) analizinde eğri altında kalan alan GENSINI skoru için 0.587 olarak hesaplandı. GENSINI skorunun 50.75’ in üzerinde olmasının POAF gelişiminin öngörülmesinde  % 82.4 duyarlılığa sahip olduğu saptandı [p=0.012, 95%CI (0.464-0.711) ].

Sonuç: Çalışmamızda GENSINI skorunun pompa destekli bypass cerrahisi uygulanan hastalarda POAF gelişiminin bağımsız bir öngördürücüsü olduğu bulunmuştur.

Anahtar Kelimeler

• Atriyal fibrilasyon,koroner arter baypas greftleme,gensini skoru

Kaynakça

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