The Validation of the ATRIA and CHA<sub>2</sub>DS<sub>2</sub>-Vasc Scores in Predicting Atrial Fibrillation after Coronary Artery Bypass Surgery

Uysal, Dinçer; Aksoy, Fatih; Ibrişim, Erdogan

doi:10.21470/1678-9741-2019-0274

Dinçer Uysal

MD

Department of Cardiovascular Surgery, Medical School, Suleyman Demirel University, Isparta, Turkey.

Fatih Aksoy

MD

Department of Cardiology, Medical School, Suleyman Demirel University, Isparta, Turkey.

https://orcid.org/0000-0002-6480-4935

Erdogan Ibrişim

MD

Department of Cardiovascular Surgery, Medical School, Suleyman Demirel University, Isparta, Turkey.

Fatih Aksoy Suleyman Demirel Univesitesi Tip Fakultesi Doğu Kampüsü Çünür/Isparta, Turkey Zip Code: 32260 E-mail: dr.aksoy@hotmail.com

No conflict of interest.

Figures (1)
Tables (6)

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Fig. 1
Receiver operating characteristics (ROC) curve analysis of risk scores. CHA2DS2-VASc stands for congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, previous stroke, vascular disease, age 65 to 74 years, and female gender. ATRIA=Anticoagulation and Risk Factors in Atrial Fibrillation

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Abbreviations, acronyms & symbols AF ALT AST ATRIA AUC CABG CI CVA HDL = Atrial fibrillation = Alanine aminotransferase = Aspartate aminotransferase = Anticoagulation and Risk Factors in Atrial Fibrillation = Area under the curve = Coronary artery bypass grafting = Confidence interval = Cerebrovascular accident = High-density lipoprotein IVSD LDL LVEDD LVESD OR POAF PWD ROC TIA = Interventricular septum diameter = Low-density lipoprotein = Left ventricular end-diastolic diameter = Left ventricular end-systolic diameter = Odds ratio = Postoperative atrial fibrillation = Posterior wall diameter = Receiver operating characteristics = Transient ischemic attack

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Table 1
Demographic and clinical characteristics of patients with and without atrial fibrillation (AF).

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Table 2
Operative and postoperative parameters of the groups.

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Table 3
Univariate regression analysis of study variables.

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Table 4
Multivariate regression analysis of study variables.

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Authors' roles & responsibilities DUFAEI Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; final approval of the version to be publishedSubstantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; final approval of the version to be publishedSubstantial contributions to the conception or design of the work; or the acquisition, final approval of the version to be published

Abbreviations, acronyms & symbols
AF ALT AST ATRIA AUC CABG CI CVA HDL	= Atrial fibrillation = Alanine aminotransferase = Aspartate aminotransferase = Anticoagulation and Risk Factors in Atrial Fibrillation = Area under the curve = Coronary artery bypass grafting = Confidence interval = Cerebrovascular accident = High-density lipoprotein		IVSD LDL LVEDD LVESD OR POAF PWD ROC TIA	= Interventricular septum diameter = Low-density lipoprotein = Left ventricular end-diastolic diameter = Left ventricular end-systolic diameter = Odds ratio = Postoperative atrial fibrillation = Posterior wall diameter = Receiver operating characteristics = Transient ischemic attack

	Without AF (n = 260)	With AF (n = 110)	P-value
Age (years)	59.8±12	68.1±8.4	< 0.001
Body mass index	29.0±5.3	28.0±4.5	0.114
Female gender (n, %)	82 (31.5)	24 (21.8)	0.03
Diabetes mellitus (n, %)	108 (41.5)	62 (56.4)	0.006
Hypertension (n, %)	184 (70.8)	100 (90.8)	< 0.001
Congestive heart failure (n, %)	12 (4.7)	20. (18.9)	< 0.001
Peripheral vascular disease (n, %)	70(26.9)	46(41.8)	0.004
History of CVA (n, %)	36 (13.8)	24 (21.8)	0.04
Ejection fraction (%)	56.5±9.4	49.2±11.6	< 0.001
Left atrial diameter (mm)	39.1±6.1	38.9±7.4	0.816
LVEDD (mm)	47.2±5.4	46.6±5.0	0.296
LVESD (mm)	29.6±6.8	31.3±5.7	0.026
IVSD (mm)	12.0±3.2	12.5±2.8	0.175
PWD (mm)	11.1±2.2	11.2±1.0	0.835
Aortic diameter (mm)	26.8±3.6	26.6±3.1	0.580
Total cholesterol (mg/dl)	201.2±41.3	196.9±39.4	0.412
HDL cholesterol (mg/dl)	41±10	42±9.8	0.713
LDL cholesterol (mg/dl)	126±40	125±34	0.915
Triglycerides (mg/dl)	160±106	142±49	0.209
Creatinine (mg/dl)	1.0±0.3	1.1±0.4	0.161
ALT (U/L)	22.2±12.2	27.5±29.8	0.015
AST (U/L)	31.1±23.6	33.0±22.7	0.489
Glucose (mg/dl)	142.5±67	198.6±119.9	< 0.001
CHA₂DS₂VASc score	2.2±1.4	3.1±1.9	< 0.001
ATRIA risk score	1.9±2.4	3.4±2.5	< 0.001

	Without AF (n = 260)	With AF (n = 110)	P-value
Cardiopulmonary bypass time (min)	78.8±27.3	86.8±39.6	0.02
Clamp time (min)	47.6±15.4	47.0±16.4	0.766
24-hour drainage (ml)	276.5±137	344.5±239	0.001
48-hour drainage (ml)	145.3±82	162.7±71.1	0.05
Duration of the hospitalization at the intensive care unit (days)	2.1±0.4	2.6±1.4	< 0.001
Bypass number (n)	2.4±2	2.4±0.7	0.806
Reoperation due to hemorrhage (n, %)	4 (1.5)	2 (1.8)	0.575
Intraoperative mortality (n, %)	-	-
In-hospital mortality (n, %)	8 (3.1)	4 (3.6)	0.500

	Odds ratio	Confidence interval	P-value
CHA₂DS₂-VASc risk score	1.38	1.21-1.59	< 0.001
ATRIA risk score	1.24	1.14-1.36	< 0.001
Fasting glucose level	1.007	1.004-1.009	< 0.001
Age	1.08	1.05-1.11	< 0.001
Male gender	1.65	0.97-2.78	0.06
ALT level	1.014	1.00-1.02	0.03
24-hour drainage	1.002	1.001-1.003	0.001
48-hour drainage	1.003	1.000-1.005	0.056
Left ventricular ejection fraction	0.93	0.91-0.96	< 0.001
Cardiopulmonary bypass time	1.008	1.001-1.015	0.03

	Model 1			Model 2
	Odds ratio	Confidence interval	P-value	Odds ratio	Confidence interval	P-value
24-hour drainage	1.002	1.001-1.004	0.002	1.002	1.001-1.004	< 0.001
Age	1.10	1.06-1.14	< 0.001
Male gender	1.94	0.93-4.07	0.076
Left ventricular ejection fraction	0.91	0.89-0.94	< 0.001
ATRIA risk score				1.232	1.11-1.36	< 0.001
Fasting glucose level	1.009	1.006-1.013	< 0.001	1.006	1.004-1.009	< 0.001
Serum ALT level	1.022	1.001-1.043	0.038

Authors' roles & responsibilities

DU
FA
EI

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; final approval of the version to be published
Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; final approval of the version to be published
Substantial contributions to the conception or design of the work; or the acquisition, final approval of the version to be published

[1] Fatih Aksoy Suleyman Demirel Univesitesi Tip Fakultesi Doğu Kampüsü Çünür/Isparta, Turkey Zip Code: 32260 E-mail: dr.aksoy@hotmail.com

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The Validation of the ATRIA and CHA₂DS₂-Vasc Scores in Predicting Atrial Fibrillation after Coronary Artery Bypass Surgery

Abstract

Objective:

Methods:

Results:

Conclusion:

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The Validation of the ATRIA and CHA2DS2-Vasc Scores in Predicting Atrial Fibrillation after Coronary Artery Bypass Surgery

Abstract

Objective:

Methods:

Results:

Conclusion:

The Validation of the ATRIA and CHA₂DS₂-Vasc Scores in Predicting Atrial Fibrillation after Coronary Artery Bypass Surgery