Korean Circ J.  2016 Nov;46(6):798-803. 10.4070/kcj.2016.46.6.798.

Is SYNTAX Score Predictive of Atrial Fibrillation after On-Pump Coronary Artery Bypass Graft Surgery?

• Cerit L
• Duygu H
• Gulsen K
• Kemal HS
• Ozcem B
• Balcioglu
• Gunsel A
• Tosun O
• Emren V

• KMID: 2355455
• DOI: http://doi.org/10.4070/kcj.2016.46.6.798

Abstract

BACKGROUND AND OBJECTIVES
The relationship of synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score and development of atrial fibrillation (AF) after coronary artery bypass surgery (CABG) has not been studied. Therefore, we assessed the relationship between the SYNTAX score and development of AF after CABG (POAF).
SUBJECTS AND METHODS
The medical records of consecutive patients, who underwent CABG surgery from January 2013 to September 2015, were retrospectively reviewed for the development of AF in the postoperative period. SYNTAX score, clinical and echocardiographic parameters were evaluated. The independent variables for the development of POAF were defined and their predictive values were measured.
RESULTS
The study group consisted of 106 patients, of which 36 (34%) developed POAF. Age, hypertension, stroke, chronic obstructive pulmonary disease (COPD), heart failure (HF), diabetes mellitus (DM), left atrial diameter, neutrophil/lymphocyte ratio, platelet large cell ratio, creatinine, blood urea nitrogen and SYNTAX score were identified as important variables for the development of POAF. However, in logistic regression analysis COPD (OR=19.313, 95% CI=2.416-154.407, p=0.005), HF (OR=28.362, 95% CI=2.034-395.515, p=0.013), SYNTAX score (OR=0.863, 95% CI=0.757-0.983, p=0.026), and DM (OR=20.770, 95% CI=3.791-113.799, p<0.001) appeared as independent variables predicting the development of POAF. In receiver operation characteristic analysis, SYNTAX score (≥22.25) (AUC=0.777, 95% CI=0.676-0.877, p<0.001) was one of the strongest predictors for the development of POAF.
CONCLUSION
The SYNTAX score level was independently associated with the development of AF after CABG.

Keyword

Atrial fibrillation; Coronary artery bypass surgery; Coronary artery disease

MeSH Terms

Atrial Fibrillation*
Blood Platelets
Blood Urea Nitrogen
Coronary Artery Bypass*
Coronary Artery Disease
Coronary Vessels*
Creatinine
Diabetes Mellitus
Echocardiography
Heart Failure
Humans
Hypertension
Logistic Models
Medical Records
Percutaneous Coronary Intervention
Postoperative Period
Pulmonary Disease, Chronic Obstructive
Retrospective Studies
Stroke
Taxus
Thoracic Surgery
Creatinine

Figure

• 

  Fig. 1 ROC curve for SYNTAX score for predicting postoperative atrial fibrillation. ROC: receiver operation characteristic, SYNTAX: synergy between percutaneous coronary intervention with taxus and cardiac surgery.

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