Liang-Ping Zhao1, Theodoros Kofidis2, Toon-Wei Lim1, Siew-Pang Chan3, Thun-How Ong4, Huay-Cheem Tan1, Chi-Hang Lee5. 1. Department of Cardiology, National University Heart Centre Singapore, Singapore. 2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre Singapore, Singapore. 3. Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore; Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia. 4. Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore. 5. Department of Cardiology, National University Heart Centre Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: mdclchr@nus.edu.sg.
Abstract
PURPOSE: New-onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG) remains a prevalent problem. We investigated the relationship between sleep apnea and new-onset post-CABG AF during inhospital stay. MATERIALS AND METHODS: We prospectively recruited 171 patients listed for an elective CABG for an overnight sleep study. Sleep apnea was defined as apnea-hypopnea index greater than or equal to 5. RESULTS: Among the 160 patients who completed the study, those in the sleep apnea group (n=128; 80%) had larger left atrial diameter (40.4±5.4 vs 38.4±6.0 mm; P=.03) and left ventricular end-diastolic dimension (52.6±7.9 vs 49.2±6.8 mm; P=.03) than those in the non-sleep apnea group. The incidence of new-onset post-CABG AF was higher for the sleep apnea than non-sleep apnea groups (24.8% vs 9.7%; P=.07). There was 1 inhospital death and 2 patients with acute renal failure requiring dialysis after CABG in the sleep apnea group. None of the patients developed inhospital stroke. Multiple logistic regression analysis showed that sleep apnea was an independent predictor of post-CABG AF (odds ratio, 4.4; 95% confidence interval, 1.1-18.1; P=.04). CONCLUSION: Sleep apnea is prevalent in patients undergoing CABG. It increases the susceptibility to new-onset AF after CABG, probably related to atrial and ventricular remodeling.
PURPOSE: New-onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG) remains a prevalent problem. We investigated the relationship between sleep apnea and new-onset post-CABG AF during inhospital stay. MATERIALS AND METHODS: We prospectively recruited 171 patients listed for an elective CABG for an overnight sleep study. Sleep apnea was defined as apnea-hypopnea index greater than or equal to 5. RESULTS: Among the 160 patients who completed the study, those in the sleep apnea group (n=128; 80%) had larger left atrial diameter (40.4±5.4 vs 38.4±6.0 mm; P=.03) and left ventricular end-diastolic dimension (52.6±7.9 vs 49.2±6.8 mm; P=.03) than those in the non-sleep apnea group. The incidence of new-onset post-CABG AF was higher for the sleep apnea than non-sleep apnea groups (24.8% vs 9.7%; P=.07). There was 1 inhospital death and 2 patients with acute renal failure requiring dialysis after CABG in the sleep apnea group. None of the patients developed inhospital stroke. Multiple logistic regression analysis showed that sleep apnea was an independent predictor of post-CABG AF (odds ratio, 4.4; 95% confidence interval, 1.1-18.1; P=.04). CONCLUSION:Sleep apnea is prevalent in patients undergoing CABG. It increases the susceptibility to new-onset AF after CABG, probably related to atrial and ventricular remodeling.
Authors: Chieh Yang Koo; Aye-Thandar Aung; Zhengfeng Chen; William Kristanto; Hui-Wen Sim; Wilson W Tam; Carlo F Gochuico; Kent Anthony Tan; Giap-Swee Kang; Vitaly Sorokin; Paul Jau Lueng Ong; Pipin Kojodjojo; Arthur Mark Richards; Huay-Cheem Tan; Theodoros Kofidis; Chi-Hang Lee Journal: Heart Date: 2020-05-18 Impact factor: 5.994
Authors: Michael K Wang; Pascal B Meyre; Rachel Heo; P J Devereaux; Lauren Birchenough; Richard Whitlock; William F McIntyre; Yu Chiao Peter Chen; Muhammad Zain Ali; Fausto Biancari; Jawad Haider Butt; Jeff S Healey; Emilie P Belley-Côté; Andre Lamy; David Conen Journal: CJC Open Date: 2021-09-16