New-Onset Atrial Fibrillation after Off-Pump Coronary Artery Bypass Grafting: Predictors and In-hospital Complications

New-Onset Atrial Fibrillation after Off-Pump Coronary Artery Bypass Grafting: Predictors and In-hospital Complications | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article New-Onset Atrial Fibrillation after Off-Pump Coronary Artery Bypass Grafting: Predictors and In-hospital Complications Hao Xu, Guangpu Fan, Yu Chen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-27299/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective To explore risk factors and in-hospital complications of new-onset atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). Methods In this study of 1344 patients who underwent isolated OPCAB from 2012 to 2015, patients were divided into AF and non-AF group according to whether new-onset postoperative AF occurred. Results The incidence of new-onset AF after OPCAB was 28.57%, mainly appeared within the first 4 days after surgery. After binary logistic regression analysis, age, peripheral vascular disease, median-sternotomy OPCAB, mechanical ventilation time, IABP were independent predictors of AF( p <0.001,OR 1.039,95%CI 1.023-1.055; p =0.007,OR 2.450,95%CI 1.282-4.684; p =0.044,OR 0.589,95%CI 0.351-0.987; p =0.013,OR 1.006,95%CI 1.001-1.011; p =0.007,OR 3.001,95%CI 1.356-6.642, respectively). Patients with AF have a significant higher risk of reoperation, re-entry into ICU, re-intubation, postoperative myocardial infarction, renal failure, and death ( p =0.013, p =0.015, p <0.001, p =0.037, p <0.001, p <0.001, respectively), also a longer re-ICU time ( p =0.014). Conclusion Advanced age, peripheral vascular disease, median-sternotomy OPCAB, mechanical ventilation time, IABP were independent predictors for new-onset AF after OPCAB. Postoperative AF was clearly associated with more in-hospital complications. Cardiac & Cardiovascular Systems OPCAB；atrial fibrillation；predictors complications Figures Figure 1 Figure 2 Background Coronary artery bypass grafting (CABG) is a usual approach of surgical revascularization performed to relieve angina, bypass atherosclerotic narrowing and improve blood supply to coronary circulation. Atrial fibrillation (AF) remains the most common arrhythmia after CABG. The incidence of post-CABG AF has been reported between 5% and 50% [ 1 ][ 2 ][ 3 ][ 4 ] , mainly occurring in the 2–4 days after surgery [ 3 ][ 5 ] . Postoperative AF is associated with worse patient mortality, prolonged hospital stay, hemodynamic disorders, and thromboembolism [ 6 ] . It is important to identify patients at high risk of developing postoperative AF, so that targeted prophylactic therapy can be given. Risk factors of AF found in previous studies include advanced age [ 4 ] , left ventricular function [ 7 ] , extracorporeal circulation [ 8 ] , and so on. However, it is still unclear which factors have a significant impact on its occurrence after this procedure. Research on predictive factors of new-onset AF after CABG is still of great clinical significance. Previous studies have found that inadequate myocardial protection during the cardiopulmonary bypass increase the risk of AF after CABG. Off-pump coronary artery bypass grafting (OPCAB) avoid the inherent risks of cardiopulmonary bypass and cardioplegic arrest, and it has less interference in patients' circulation [ 9 ] . At present, there are few studies on the risk factors of new-onset AF after OPCAB, and there in no consensus about predictive factors of post-OPCAB AF. Therefore, this study aims to explore the risk factors of new-onset AF after OPCAB and identify the potential impact of postoperative AF on the in-hospital complications. Methods A total of 1406 patients who underwent selected and isolated OPCAB in Peking University People's Hospital from January 1, 2012 to December 30, 2015 were selected for this study. The excluded criteria included history of AF, non-sinus rhythm, congenital heart disease, concomitant surgery, valvular heart disease, cardiac pacemaker implantation and incomplete clinical data. Sixty two patients were excluded, 22 of whom had a history of AF; 22 patients had incomplete data; 6 patients were non-sinus rhythm; 7 had pacemakers installed before surgery, and 5 had concomitant carotid endarterectomy. The final study cohort included 1344 patients. Patients were divided into AF group and non-AF group according to whether they had new-onset AF after OPCAB. AF was defined as any episode of AF noted by continuous ECG/telemetry monitoring, or documented by a physician in the chart, lasting for 30 s or more. This study was approved by the Ethics Committee of Peking university people’s hospital. The present study includes multiple pre, intra, and post OPCAB variables (Tables 1 and 2). Types of OPCAB include conventional median-sternotomy OPCAB (cOPCAB) and minimally invasive coronary artery bypass grafting (MID-OPCAB). The laboratory and ultrasound data are the values of the final check before surgery. Perioperative medicine history and in-hospital complications were recorded carefully. In our study, two researchers collected clinical data, and the data between them had a high consistency. If there were controversies, the two researchers negotiated and resolved. Table 1 Preoperative characteristics of patients AF group n = 384 Non-AF group n = 960 p Age(year) 64.14 ± 8.60 61.16 ± 8.90 <0.001 Male(n,%) 285(74.2%) 695(72.4%) 0.497 BMI(kg/m 2 ) 25.56 ± 3.25 25.91 ± 12.38 0.582 MI history(n,%) 137(35.7%) 309(32.2%) 0.220 Previous PCI (n,%) 35(9.1%) 86(9.0%) 0.928 Previous CABG(n,%) 2(0.5%) 9(0.9%) 0.738 Smoking situation 0.722 Previous smoking(n,%) 83(21.6%) 189(19.7%) Current smoking(n,%) 99(25.8%) 250(26.0%) Diabetes mellitus 0.192 Diet control(n,%) 25(6.5%) 59(6.1%) Oral medication(n,%) 71(18.5%) 167(17.4%) insulin(n,%) 48(12.5%) 86(9.0%) Hypertension(n,%) 235(61.2%) 564(58.8%) 0.409 Hyperlipidemia(n,%) 69(18.0%) 141(14.7%) 0.134 COPD(n,%) 7(1.8%) 11(1.1%) 0.329 Peripheral vascular disease(n,%) 21(5.5%) 24(2.5%) 0.006 Cerebrovascular disease(n,%) 54(14.1%) 116(12.1%) 0.324 Thyroid disease 0.473 Hypothyroidism(n,%) 4(1.0%) 8(0.8%) Hyperthyroidism(n,%) 3(0.8%) 3(0.3%) Coronary heart disease 0.730 stable angina (n,%) 114(29.7%) 315(32.8%) Unstable angina(n,%) 257(66.9%) 613(63.9%) STEMI(n,%) 7(1.8%) 16(1.7%) NSTEMI(n,%) 6(1.6%) 16(1.7%) NYHA Class 0.265 NYHA I(n,%) 49(12.8%) 133(13.9%) NYHA II(n,%) 195(50.8%) 504(52.5%) NYHA III(n,%) 127(33.1%) 280(29.2%) NYHA IV(n,%) 13(3.4%) 43(4.5%) Number of coronary artery lesion 0.045 1 vessel(n,%) 20(5.2%) 87(9.1%) 2 vessel(n,%) 32(8.3%) 70(7.3%) 3 vessel(n,%) 332(86.5%) 803(83.6%) 4 vessel(n,%) 60(15.6%) 177(18.4%) Preoperative medications Nitrate(n,%) 223(58.1%) 542(56.5%) 0.589 Catecholamine(n,%) 3(0.8%) 8(0.8%) 1 Beta blockers(n,%) 348(90.6%) 882(91.9%) 0.457 ACEI/ARB(n,%) 103(26.8%) 233(24.3%) 0.329 Statins(n,%) 331(86.2%) 829(86.4%) 0.940 Aspirin(n,%) 305(79.4%) 752(78.3%) 0.658 Clopidogrel(n,%) 14(3.6%) 39(4.1%) 0.723 Creatinine(umol/L) 79.21 ± 47.09 74.81 ± 46.80 0.120 Total cholesterol(mmol/L) 4.00 ± 1.02 4.00 ± 1.03 0.972 LDL(mmol/L) 2.383 ± 0.82 2.38 ± 0.84 0.999 LVEF(%) 61.15(16,78.6) 63.60(24.9,85.6) 0.001 LVEDD(cm) 5.34 ± 3.39 5.29 ± 3.95 0.816 LVESD(cm) 3.53 ± 0.79 3.38 ± 1.18 0.026 Left atrium diameters(cm) 3.80(2.3,5.1) 3.60(2,6.4) <0.001 ACEI, ACE inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; CABG,coronary artery bypass grafting; COPD, chronic obstructive pulmonary disease; LDL, low-density lipoprotein; LVEF, left ventricular ejection fraction; LVEDD, left ventricular end diastolic diameter; LVESD left ventricular end systolic diameter;MI, Myocardial infarction; NSTEMI, non-ST-elevation myocardial infarction༛NYHA, New York Heart Association; PCI, percutaneous coronary intervention; STEMI, ST-segment elevation myocardial infarction. All patients were admitted into ICU after surgery and underwent continuous hardwire monitoring of blood pressure, pulse, electrocardiogram. After the patient leaved the ICU, continuous telemetry monitoring of blood pressure, pulse, electrocardiogram would be performed until discharge. Patients were checked for blood tests, liver and kidney function immediately and daily after surgery. If the patient did not have any contraindications, nitroglycerin, β-blocker, and antiplatelet drugs were routinely given after the operation. No other prophylactic therapies were taken to prevent postoperative arrhythmia. Other drugs were given according to the patient's condition. If ECG monitoring showed that AF occured, a 12-lead ECG and blood gas examination would be performed at the same time. And the patient would be given oral or intravenous amiodarone. All patients were converted into sinus rhythm before discharging. No patients required electrical cardioversion. The Kolmogorov-Smirnov test was used to check the normality of continuous variables. If they conformed to the normal distribution, they were described by mean ± standard deviation. Otherwise, they were described by median (minimum, maximum). Categorical variables were expressed as numbers and percentages. Continuous variables were analyzed by t -tested,and categorical variables were compared by Mann–Whitney U test or Chi-square test/ Fisher’s exact test. Independent predictors of AF were then determined by a binary logistic regression analysis of those variables found to have a P -value < 0.10 on univariate analysis. A bilateral p -value < 0.05 were considered statistically significant. Statistical analyses were performed using SPSS 24.0. Results From January 1, 2012 to December 30, 2015, 384 of the 1344 patients (28.57) who underwent isolated OPCAB developed postoperative new-onset AF. The average age is 61.96 ± 9.03 years (29–84 years), 981 patients are males(73.0%). The majority of AF appeared within the first 4 days after surgery, and the peak frequency is in the 2nd postoperative day (Fig. 1). Advanced age was associated with an increase in AF ( p < 0.001), and the proportion of peripheral vascular diseases was significantly higher in patients with AF ( p = 0.006). There was a significant difference in the number of coronary artery lesions between two groups ( p = 0.045). Patients in AF group had a lower ejection fraction, larger LVESD and left atrium diameters compared to those without postoperative AF ( p = 0.001, p = 0.026, p <0.001, respectively). (Table 1 ) In AF group, 93.5% of patients received cOPCAB and 6.5% underwent MID-OPCAB. Proportions of cOPCAB and MID-OPCAB in non-AF patients were 85.4% and 14.6%, respectively. There was a significant difference between the two types of OPCAB and AF( p <0.001). In addition, ICU time and mechanical ventilation time were significantly longer in the AF group ( p < 0.001, p < 0.001, respectively). Patients with AF had a high risk of using IABP ( p < 0.001),and they also had higher postoperative maximum TNI level ( p = 0.001). There was no difference in the units of blood products transfused during surgery between two groups, but the total units of transfused red blood cells, plasma, and platelet in the AF group were significantly larger than that in the non-AF group ( p < 0.001, p < 0.001༌ p = 0.003༌respectively). Patients with AF had more drainage after surgery ( p = 0.010). (Table 2) In a binary logistic regression analysis, age ( p <0.001,OR 1.039༌95%CI 1.023–1.055), peripheral vascular disease ( p =0.007༌OR 2.450༌95%CI 1.282–4.684), cOPCAB ( p ༝0.044༌OR 0.589༌95%CI 0.351–0.987), mechanical ventilation time ( p ༝0.013༌OR 1.006༌95%CI 1.001–1.011), use of IABP ( p ༝0.007༌OR 3.001༌95%CI 1.356–6.642) remained independently predictive of new-onset AF after OPCAB. ICU time and mechanical ventilation time were all significantly different between two groups in the univariate analysis. However, after adjusted by binary logistic regression analysis, mechanical ventilation time was the only one significantly longer in the AF group (Table 3 ). Table 2: Patients' intraoperative and postoperative characteristics AF group n = 384 Non-AF group n = 960 p OPCAB <0.001 cOPCAB(n,%) 359(93.5%) 820(85.4%) MID-OPCAB(n,%) 25(6.5%) 140(14.6%) Units of intraoperative blood products Red blood cells(U) 0.39 ± 1.18 0.40 ± 1.25 0.777 Plasma(ml) 32.81 ± 128.73 33.33 ± 119.67 0.946 Platelets(U) 0.01 ± 0.10 0 0.114 ICU time(h) 46.50(7,198.23) 39(5,500) <0.001 Mechanical ventilation time(h) 17(2,1100) 12(0,465) <0.001 IABP(n,%) 36(9.4%) 14(1.5%) <0.001 Postoperative maximum TNI(ng/mL) 0.83(0.003–225.68) 0.64(0.01–234.20) 0.001 Total units of blood products Red blood cells(U) 4(0,124) 0(0,52) <0.001 Plasma(ml) 800(0,7400) 600(0,6600) <0.001 Platelets(U) 0(0,5) 0(0,5) 0.003 Drainage(mL) 980(170,5580) 930(100,5010) 0.010 cOPCAB, conventional median-sternotomy OPCAB; IABP, intra-aortic balloon pump; ICU, intensive care unit; MID-OPCAB, minimally invasive direct coronary artery bypass grafting; TNI, troponin-I. Patients in the AF group had more requirements for reoperation (5.5% vs 2.7%, p = 0.013), mainly due to bridge problems (vessel occlusion or insufficient blood flow), bleeding or pericardial tamponade, and chest incision problems (Fig. 2). The risks of re-entry into ICU, re-intubation, postoperative myocardial infarction, and renal failure in the AF group were significantly greater ( p = 0.015; p < 0.001; p = 0.037; p < 0.001, respectively). Similarly, there was also a statistical difference in re-ICU time between the two groups (p = 0.014).In-hospital mortality was 22 patients (5.7%) in the AF group in comparison to 5 patients (0.5%) in the non-AF group with a p-value < 0.001 (Table 4 ). Table 3 Table 3: Results of binary logistic regression analysis p OR 95% CI Age <0.001 1.039 1.023–1.055 Peripheral vascular disease 0.007 2.450 1.282–4.684 cOPCAB 0.044 0.589 0.351–0.987 Mechanical ventilation time 0.013 1.006 1.001–1.011 IABP 0.007 3.001 1.356–6.642 cOPCAB, conventional median-sternotomy OPCAB; IABP, intra-aortic balloon pump. Table 4 In-hospital complications of patients AF group n = 384 Non-AF group n = 960 p Reoperation(n,%) 21(5.5%) 26(2.7%) 0.013 Re-entry into ICU(n,%) 13(3.4%) 13(1.4%) 0.015 Re-ICU time(h) 0(0,408) 0(0,381) 0.014 Re-intubation(n,%) 15(3.9%) 6(0.6%) <0.001 Myocardial infarction(n,%) 8(2.1%) 6(0.6%) 0.037 Stroke(n,%) 4(1.0%) 6(0.6%) 0.484 Renal failure(n,%) 36(9.4%) 7(0.7%) <0.001 Death (n,%) 22(5.7%) 5(0.5%) <0.001 ICU, intensive care unit. Discussion The present study found that the new-onset AF after OPCAB was concentrated within the first 4 days after surgery, which is consistent with previous studies [ 3 ][ 5 ] . The incidence of AF in our study was 28.75% within the incidence of prior studies [ 1 ][ 2 ][ 3 ] . Age is one of the most consistent risk factors for postoperative AF in many previous literature [ 4 ][ 10 ][ 11 ][ 12 ][ 13 ][ 14 ][ 15 ] , which was also supported by our research. The effect of advanced age on AF may relate to degenerative changes in atrial structure and function [ 11 ] . Studies have found that patients with peripheral vascular disease had a high probability of being accompanied by atherosclerosis of other blood vessels [ 16 ] , and the risk of cardiovascular events increases with the severity of peripheral vascular disease [ 17 ] [ 18 ] . Our study found that peripheral vascular disease was an independent risk factor for new-onset AF after OPCAB, which is consistent with the conclusions of Pollock et al. Their study included 9416 patients with isolated CABG in multiple centers, and found that patients with peripheral vascular disease were more likely to develop new-onset postoperative AF [ 19 ] . OPCAB mainly includes two types of procedures: cOPCAB and MID-OPCAB. To our best knowledge, there are currently no studies especially focus on the relationship between the two types of OPCAB and postoperative new-onset AF. In this study, the binary logistic regression analysis showed that patients underwent cOPCAB had a significant more risk of postoperative AF than patients had MID-OPCAB. Nevertheless, it is also noteworthy that patients undergoing MID-OPCAB were younger, had better cardiac function and fewer coronary vessel lesions. Most previous studies involved just one of ICU time and mechanical ventilation time, and rarely combined analysis of the two [ 12 ][ 20 ] . Different from other studies, we included two variables mentioned above and found that only mechanical ventilation time was an independent risk factor of AF after OPCAB. Supporting our results, Filardo et al. had the same result from their study [ 3 ] , and they reported that both ICU time and mechanical ventilation time were statistically associated with postoperative AF in the univariate analysis, but mechanical ventilation time is the only one correlated significantly with AF after analyzed by logistic analysis. In the present study, the proportion of patients with AF using IABP was significantly higher than that of non-AF. IABP is not a variable often included in previous research. Consistent with our findings, Lewicki et al. conducted a study included 1836 patients who underwent CABG and identified that IABP was an independent predictor of new-onset AF after CABG [ 15 ] . Inversely, Thoren et al. disagreed with this conclusion [ 21 ] .It might be due to the fact that the majority of the operations (96%) were performed on-pump in their study cohort, which is dramatically different from ours. New-onset AF was clearly associated with more in-hospital complications. Similar to previous studies, we found patients with postoperative AF had higher risk of reoperation, re-intubation, postoperative myocardial infarction, stroke, renal failure, and in-hospital death [ 2 ] [ 6 ] [ 15 ] [ 22 ] [ 23 ] . However, we could not show any association between postoperative stroke and AF, which was supported by previous studies [ 2 ] [ 6 ] [ 22 ] . This might result from the fact that our study excluded patients who underwent concomitant valve surgery and only concentrated on in-hospital complications. To our best knowledge, previous studies of AF after CABG did not include re-entry into ICU and re-ICU time. From our study, we, firstly, demonstrated that the two variables above are all statistically significant between the two groups. This is a retrospective single center observational study. One of the major limitations is intrinsic to the observational nature of this study, which cannot adjust for unobserved or unknown confounders. Furthermore, the Chinese patient population might limit the generalizability of these reported findings. Finally, given the AF definition that the abnormal atrial originated rhythm be documented for at least 30 s, it is possible that the overall rate for AF occurrences may have been underreported. Conclusions In summary, the present study found that the incidence of new-onset AF after OPCAB was 28.57%, which mainly occurred within the first 4 days after surgery. Age, peripheral vascular disease, cOPCAB, mechanical ventilation time, IABP use were independent predictors of new-onset AF after OPCAB. Patients with new-onset AF have significantly more in-hospital complications than those without AF. Declarations Ethics approval and consent to participate: This study compiled with the Declaration of Helsinki and the study protocols were approved by the ethics committee of Peking university people’s hospital. Waiving the requirement for obtaining written informed consents was allowed by the ethics committee of Peking university people’s hospital, because the retrospective and observational nature of this study. Consent for publication Not applicable. Availability of data and materials All data generated or analysed during this study are included in this published article and its supplementary information files. Competing interests The authors declare that they have no competing interests. Funding Not applicable. Authors' contributions Xu Hao performed the statistical analysis, data curation and writing the original draft；Fan Guangpu performed the data Curation；Chen Yu is in chargr og conceptualization, methodology and writing the editing.All authors read and approved the final manuscript Acknowledgements Not applicable. References Vidotti E, Vidotti L, Arruda TC, Ferraz E, Oliveira V, de Andrade AG, Cardoso J, Cardoso MH. Predicting postoperative atrial fibrillation after myocardial revascularization without cardiopulmonary bypass: A retrospective cohort study. J Card Surg. 2019;34(7):577–82. Tsai YT, Lai CH, Loh SH, Lin CY, Lin YC, Lee CY, Ke HY, Tsai CS. Assessment of the Risk Factors and Outcomes for Postoperative Atrial Fibrillation Patients Undergoing Isolated Coronary Artery Bypass Grafting. ACTA CARDIOL SIN. 2015;31(5):436–43. Filardo G, Damiano RJ, Ailawadi G, Thourani VH, Pollock BD, Sass DM, Phan TK, Nguyen H, Da GB. 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Increased risk of atrial fibrillation among patients undergoing coronary artery bypass graft surgery while receiving nitrates and antiplatelet agents. J INT MED RES. 2018;46(8):3183–94. Thoren E, Hellgren L, Granath F, Horte LG, Stahle E. Postoperative atrial fibrillation predicts cause-specific late mortality after coronary surgery. SCAND CARDIOVASC J. 2014;48(2):71–8. Boning A, Diegeler A, Hilker M, Zacher M, Reents W, Faerber G, Doenst T. Preoperative atrial fibrillation and outcome in patients undergoing on-pump or off-pump coronary bypass surgery: lessons learned from the GOPCABE trial. Interact Cardiovasc Thorac Surg. 2015;20(1):74–8. Ferreira AF, Moreira ASF, Pinho RJCR,JAM. P, P LA, F LA: Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting Surgery. Rev Port Cir Cardiotorac Vasc. 2017;24(3–4):129. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-27299","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":552869,"identity":"03742408-0e83-44ec-80a0-a1f84b6511f3","order_by":1,"name":"Hao Xu","email":"","orcid":"","institution":"Peking University People's Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Hao","middleName":"","lastName":"Xu","suffix":""},{"id":552870,"identity":"6392e11b-b97d-40ee-8395-3e43c0b9d876","order_by":2,"name":"Guangpu Fan","email":"","orcid":"","institution":"Peking University People's Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Guangpu","middleName":"","lastName":"Fan","suffix":""},{"id":552871,"identity":"ceb35baf-e9d0-410b-aae1-79ce71698044","order_by":3,"name":"Yu Chen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0UlEQVRIiWNgGAWjYDACCTDJDOF8MLCxI0ELGwMD44yCtGTStDDzfDjE2EBIB//s5mOPedus5fjnNx/7bGNwgJmB/fDRDXgtuXMs3Zi3Ld1Y4hhb8uwcgzt8DDxpaTfwaTGQyDGT5m07nLiBjceYOcfgGTODBI8ZAS353xBaLAwOMzYQ1pLDhtDCQIwWiRtpZpJzzoH8kpbM2GOQlsxGyC/8M5KfSbwpA4ZY8+HDDD/+2Njxsx8+hlcLCDDxIPPYCCkHAcYfxKgaBaNgFIyCkQsAt4tBAn2LO1EAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0001-7210-5942","institution":"Peking University People's Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Yu","middleName":"","lastName":"Chen","suffix":""}],"badges":[],"createdAt":"2020-05-06 23:36:30","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-27299/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-27299/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":1073592,"identity":"2d1c8a77-a6fd-4c76-a989-37edf2f3ec66","added_by":"auto","created_at":"2020-05-11 21:39:15","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":65226,"visible":true,"origin":"","legend":"Time distribution of new-onset AF after OPCAB","description":"","filename":"fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-27299/v1/fig1.png"},{"id":1073593,"identity":"624e5911-34fc-471c-9354-44d7c23aa6cf","added_by":"auto","created_at":"2020-05-11 21:39:15","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":24772,"visible":true,"origin":"","legend":"Distribution of causes for reoperation","description":"","filename":"fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-27299/v1/fig2.png"},{"id":13502881,"identity":"1730d408-63cc-4215-acd7-94ef0cca52cd","added_by":"auto","created_at":"2021-09-16 23:16:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":309660,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-27299/v1/1d27fe52-8235-4207-acd8-fc289e4e61d5.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eNew-Onset Atrial Fibrillation after Off-Pump Coronary Artery Bypass Grafting: Predictors and In-hospital Complications\u003c/p\u003e","fulltext":[{"header":"Background","content":" \u003cp\u003eCoronary artery bypass grafting (CABG) is a usual approach of surgical revascularization performed to relieve angina, bypass atherosclerotic narrowing and improve blood supply to coronary circulation. Atrial fibrillation (AF) remains the most common arrhythmia after CABG. The incidence of post-CABG AF has been reported between 5% and 50% \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e][\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e][\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e][\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e, mainly occurring in the 2\u0026ndash;4 days after surgery \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e][\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. Postoperative AF is associated with worse patient mortality, prolonged hospital stay, hemodynamic disorders, and thromboembolism \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. It is important to identify patients at high risk of developing postoperative AF, so that targeted prophylactic therapy can be given. Risk factors of AF found in previous studies include advanced age \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e, left ventricular function \u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e, extracorporeal circulation \u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e, and so on. However, it is still unclear which factors have a significant impact on its occurrence after this procedure. Research on predictive factors of new-onset AF after CABG is still of great clinical significance.\u003c/p\u003e \u003cp\u003ePrevious studies have found that inadequate myocardial protection during the cardiopulmonary bypass increase the risk of AF after CABG. Off-pump coronary artery bypass grafting (OPCAB) avoid the inherent risks of cardiopulmonary bypass and cardioplegic arrest, and it has less interference in patients' circulation \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. At present, there are few studies on the risk factors of new-onset AF after OPCAB, and there in no consensus about predictive factors of post-OPCAB AF. Therefore, this study aims to explore the risk factors of new-onset AF after OPCAB and identify the potential impact of postoperative AF on the in-hospital complications.\u003c/p\u003e "},{"header":"Methods","content":" \u003cp\u003eA total of 1406 patients who underwent selected and isolated OPCAB in Peking University People's Hospital from January 1, 2012 to December 30, 2015 were selected for this study. The excluded criteria included history of AF, non-sinus rhythm, congenital heart disease, concomitant surgery, valvular heart disease, cardiac pacemaker implantation and incomplete clinical data. Sixty two patients were excluded, 22 of whom had a history of AF; 22 patients had incomplete data; 6 patients were non-sinus rhythm; 7 had pacemakers installed before surgery, and 5 had concomitant carotid endarterectomy. The final study cohort included 1344 patients. Patients were divided into AF group and non-AF group according to whether they had new-onset AF after OPCAB. AF was defined as any episode of AF noted by continuous ECG/telemetry monitoring, or documented by a physician in the chart, lasting for 30\u0026nbsp;s or more. This study was approved by the Ethics Committee of Peking university people\u0026rsquo;s hospital.\u003c/p\u003e \u003cp\u003eThe present study includes multiple pre, intra, and post OPCAB variables (Tables\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and 2). Types of OPCAB include conventional median-sternotomy OPCAB (cOPCAB) and minimally invasive coronary artery bypass grafting (MID-OPCAB). The laboratory and ultrasound data are the values of the final check before surgery. Perioperative medicine history and in-hospital complications were recorded carefully. In our study, two researchers collected clinical data, and the data between them had a high consistency. If there were controversies, the two researchers negotiated and resolved.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePreoperative characteristics of patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAF group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;384\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-AF group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;960\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge(year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64.14\u0026thinsp;\u0026plusmn;\u0026thinsp;8.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61.16\u0026thinsp;\u0026plusmn;\u0026thinsp;8.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e285(74.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e695(72.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.497\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.56\u0026thinsp;\u0026plusmn;\u0026thinsp;3.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.91\u0026thinsp;\u0026plusmn;\u0026thinsp;12.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.582\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMI history(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e137(35.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e309(32.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.220\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrevious PCI (n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(9.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86(9.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.928\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrevious CABG(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(0.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(0.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.738\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking situation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.722\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrevious smoking(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e83(21.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e189(19.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCurrent smoking(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99(25.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e250(26.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.192\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiet control(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25(6.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59(6.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral medication(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71(18.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e167(17.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003einsulin(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48(12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86(9.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e235(61.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e564(58.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.409\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHyperlipidemia(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69(18.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e141(14.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.134\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOPD(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7(1.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(1.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.329\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeripheral vascular disease(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21(5.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(2.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCerebrovascular disease(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54(14.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e116(12.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.324\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThyroid disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.473\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypothyroidism(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(1.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(0.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHyperthyroidism(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(0.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(0.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoronary heart disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.730\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003estable angina (n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e114(29.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e315(32.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnstable angina(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e257(66.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e613(63.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSTEMI(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7(1.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNSTEMI(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6(1.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNYHA Class\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.265\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNYHA I(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49(12.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e133(13.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNYHA II(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e195(50.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e504(52.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNYHA III(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e127(33.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e280(29.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNYHA IV(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13(3.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43(4.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of coronary artery lesion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.045\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 vessel(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20(5.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87(9.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2 vessel(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32(8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70(7.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3 vessel(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e332(86.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e803(83.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 vessel(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60(15.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e177(18.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreoperative medications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNitrate(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e223(58.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e542(56.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.589\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCatecholamine(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(0.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(0.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBeta blockers(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e348(90.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e882(91.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.457\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eACEI/ARB(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e103(26.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e233(24.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.329\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatins(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e331(86.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e829(86.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.940\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAspirin(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e305(79.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e752(78.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.658\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClopidogrel(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14(3.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39(4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.723\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine(umol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79.21\u0026thinsp;\u0026plusmn;\u0026thinsp;47.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74.81\u0026thinsp;\u0026plusmn;\u0026thinsp;46.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.120\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal cholesterol(mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.00\u0026thinsp;\u0026plusmn;\u0026thinsp;1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.00\u0026thinsp;\u0026plusmn;\u0026thinsp;1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.972\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL(mmol/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.383\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.999\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLVEF(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61.15(16,78.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.60(24.9,85.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLVEDD(cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.34\u0026thinsp;\u0026plusmn;\u0026thinsp;3.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.29\u0026thinsp;\u0026plusmn;\u0026thinsp;3.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.816\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLVESD(cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.53\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.38\u0026thinsp;\u0026plusmn;\u0026thinsp;1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeft atrium diameters(cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.80(2.3,5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.60(2,6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eACEI, ACE inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; CABG,coronary artery bypass grafting; COPD, chronic obstructive pulmonary disease; LDL, low-density lipoprotein; LVEF, left ventricular ejection fraction; LVEDD, left ventricular end diastolic diameter; LVESD left ventricular end systolic diameter;MI, Myocardial infarction; NSTEMI, non-ST-elevation myocardial infarction༛NYHA, New York Heart Association; PCI, percutaneous coronary intervention; STEMI, ST-segment elevation myocardial infarction.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAll patients were admitted into ICU after surgery and underwent continuous hardwire monitoring of blood pressure, pulse, electrocardiogram. After the patient leaved the ICU, continuous telemetry monitoring of blood pressure, pulse, electrocardiogram would be performed until discharge. Patients were checked for blood tests, liver and kidney function immediately and daily after surgery. If the patient did not have any contraindications, nitroglycerin, β-blocker, and antiplatelet drugs were routinely given after the operation. No other prophylactic therapies were taken to prevent postoperative arrhythmia. Other drugs were given according to the patient's condition. If ECG monitoring showed that AF occured, a 12-lead ECG and blood gas examination would be performed at the same time. And the patient would be given oral or intravenous amiodarone. All patients were converted into sinus rhythm before discharging. No patients required electrical cardioversion.\u003c/p\u003e \u003cp\u003eThe Kolmogorov-Smirnov test was used to check the normality of continuous variables. If they conformed to the normal distribution, they were described by mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation. Otherwise, they were described by median (minimum, maximum). Categorical variables were expressed as numbers and percentages. Continuous variables were analyzed by \u003cem\u003et\u003c/em\u003e-tested,and categorical variables were compared by Mann\u0026ndash;Whitney \u003cem\u003eU\u003c/em\u003e test or Chi-square test/ Fisher\u0026rsquo;s exact test. Independent predictors of AF were then determined by a binary logistic regression analysis of those variables found to have a \u003cem\u003eP\u003c/em\u003e-value\u0026thinsp;\u0026lt;\u0026thinsp;0.10 on univariate analysis. A bilateral \u003cem\u003ep\u003c/em\u003e-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were considered statistically significant. Statistical analyses were performed using SPSS 24.0.\u003c/p\u003e "},{"header":"Results","content":" \u003cp\u003eFrom January 1, 2012 to December 30, 2015, 384 of the 1344 patients (28.57) who underwent isolated OPCAB developed postoperative new-onset AF. The average age is 61.96\u0026thinsp;\u0026plusmn;\u0026thinsp;9.03\u0026nbsp;years (29\u0026ndash;84\u0026nbsp;years), 981 patients are males(73.0%). The majority of AF appeared within the first 4\u0026nbsp;days after surgery, and the peak frequency is in the 2nd postoperative day (Fig.\u0026nbsp;1).\u003c/p\u003e \u003cp\u003eAdvanced age was associated with an increase in AF (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and the proportion of peripheral vascular diseases was significantly higher in patients with AF (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.006). There was a significant difference in the number of coronary artery lesions between two groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.045). Patients in AF group had a lower ejection fraction, larger LVESD and left atrium diameters compared to those without postoperative AF (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.026,\u003cem\u003ep\u003c/em\u003e\u003c0.001, respectively). (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eIn AF group, 93.5% of patients received cOPCAB and 6.5% underwent MID-OPCAB. Proportions of cOPCAB and MID-OPCAB in non-AF patients were 85.4% and 14.6%, respectively. There was a significant difference between the two types of OPCAB and AF(\u003cem\u003ep\u003c/em\u003e\u003c0.001). In addition, ICU time and mechanical ventilation time were significantly longer in the AF group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, respectively). Patients with AF had a high risk of using IABP (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001),and they also had higher postoperative maximum TNI level (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001). There was no difference in the units of blood products transfused during surgery between two groups, but the total units of transfused red blood cells, plasma, and platelet in the AF group were significantly larger than that in the non-AF group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001༌\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003༌respectively). Patients with AF had more drainage after surgery (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.010). (Table\u0026nbsp;2)\u003c/p\u003e \u003cp\u003eIn a binary logistic regression analysis, age (\u003cem\u003ep\u003c/em\u003e\u003c0.001,OR 1.039༌95%CI 1.023\u0026ndash;1.055), peripheral vascular disease (\u003cem\u003ep\u003c/em\u003e=0.007༌OR 2.450༌95%CI 1.282\u0026ndash;4.684), cOPCAB (\u003cem\u003ep\u003c/em\u003e༝0.044༌OR 0.589༌95%CI 0.351\u0026ndash;0.987), mechanical ventilation time (\u003cem\u003ep\u003c/em\u003e༝0.013༌OR 1.006༌95%CI 1.001\u0026ndash;1.011), use of IABP (\u003cem\u003ep\u003c/em\u003e༝0.007༌OR 3.001༌95%CI 1.356\u0026ndash;6.642) remained independently predictive of new-onset AF after OPCAB. ICU time and mechanical ventilation time were all significantly different between two groups in the univariate analysis. However, after adjusted by binary logistic regression analysis, mechanical ventilation time was the only one significantly longer in the AF group (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003e\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eTable\u0026nbsp;2: Patients' intraoperative and postoperative characteristics\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAF group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-AF group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;960\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOPCAB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ecOPCAB(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e359(93.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e820(85.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMID-OPCAB(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25(6.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e140(14.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnits of intraoperative blood products\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRed blood cells(U)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.39\u0026thinsp;\u0026plusmn;\u0026thinsp;1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.40\u0026thinsp;\u0026plusmn;\u0026thinsp;1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.777\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlasma(ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.81\u0026thinsp;\u0026plusmn;\u0026thinsp;128.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.33\u0026thinsp;\u0026plusmn;\u0026thinsp;119.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.946\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelets(U)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.114\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICU time(h)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46.50(7,198.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39(5,500)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanical ventilation time(h)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17(2,1100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(0,465)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIABP(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36(9.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14(1.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostoperative maximum TNI(ng/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.83(0.003\u0026ndash;225.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.64(0.01\u0026ndash;234.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal units of blood products\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRed blood cells(U)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(0,124)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0,52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlasma(ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e800(0,7400)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e600(0,6600)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelets(U)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0(0,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrainage(mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e980(170,5580)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e930(100,5010)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003ecOPCAB, conventional median-sternotomy OPCAB; IABP, intra-aortic balloon pump; ICU, intensive care unit; MID-OPCAB, minimally invasive direct coronary artery bypass grafting; TNI, troponin-I.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ePatients in the AF group had more requirements for reoperation (5.5% vs 2.7%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.013), mainly due to bridge problems (vessel occlusion or insufficient blood flow), bleeding or pericardial tamponade, and chest incision problems (Fig.\u0026nbsp;2). The risks of re-entry into ICU, re-intubation, postoperative myocardial infarction, and renal failure in the AF group were significantly greater (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.015; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.037; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001, respectively). Similarly, there was also a statistical difference in re-ICU time between the two groups (p\u0026thinsp;=\u0026thinsp;0.014).In-hospital mortality was 22 patients (5.7%) in the AF group in comparison to 5 patients (0.5%) in the non-AF group with a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001 (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTable 3: Results of binary logistic regression analysis\n\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.023\u0026ndash;1.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeripheral vascular disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.450\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.282\u0026ndash;4.684\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ecOPCAB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.589\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.351\u0026ndash;0.987\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanical ventilation time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.001\u0026ndash;1.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIABP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.356\u0026ndash;6.642\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003ecOPCAB, conventional median-sternotomy OPCAB; IABP, intra-aortic balloon pump.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\n\n\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIn-hospital complications of patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAF group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;384\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-AF group\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;960\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReoperation(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21(5.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(2.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRe-entry into ICU(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13(3.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13(1.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRe-ICU time(h)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0(0,408)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0,381)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRe-intubation(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15(3.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6(0.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMyocardial infarction(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(2.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6(0.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.037\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStroke(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(1.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6(0.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.484\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRenal failure(n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36(9.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(0.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeath (n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22(5.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(0.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003c0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eICU, intensive care unit.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e "},{"header":"Discussion","content":" \u003cp\u003eThe present study found that the new-onset AF after OPCAB was concentrated within the first 4 days after surgery, which is consistent with previous studies \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e][\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. The incidence of AF in our study was 28.75% within the incidence of prior studies \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e][\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e][\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. Age is one of the most consistent risk factors for postoperative AF in many previous literature \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e][\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e][\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e][\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e][\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e][\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e][\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e, which was also supported by our research. The effect of advanced age on AF may relate to degenerative changes in atrial structure and function \u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eStudies have found that patients with peripheral vascular disease had a high probability of being accompanied by atherosclerosis of other blood vessels \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e, and the risk of cardiovascular events increases with the severity of peripheral vascular disease \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. Our study found that peripheral vascular disease was an independent risk factor for new-onset AF after OPCAB, which is consistent with the conclusions of Pollock et al. Their study included 9416 patients with isolated CABG in multiple centers, and found that patients with peripheral vascular disease were more likely to develop new-onset postoperative AF \u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOPCAB mainly includes two types of procedures: cOPCAB and MID-OPCAB. To our best knowledge, there are currently no studies especially focus on the relationship between the two types of OPCAB and postoperative new-onset AF. In this study, the binary logistic regression analysis showed that patients underwent cOPCAB had a significant more risk of postoperative AF than patients had MID-OPCAB. Nevertheless, it is also noteworthy that patients undergoing MID-OPCAB were younger, had better cardiac function and fewer coronary vessel lesions.\u003c/p\u003e \u003cp\u003eMost previous studies involved just one of ICU time and mechanical ventilation time, and rarely combined analysis of the two \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e][\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e. Different from other studies, we included two variables mentioned above and found that only mechanical ventilation time was an independent risk factor of AF after OPCAB. Supporting our results, Filardo et al. had the same result from their study \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e, and they reported that both ICU time and mechanical ventilation time were statistically associated with postoperative AF in the univariate analysis, but mechanical ventilation time is the only one correlated significantly with AF after analyzed by logistic analysis.\u003c/p\u003e \u003cp\u003eIn the present study, the proportion of patients with AF using IABP was significantly higher than that of non-AF. IABP is not a variable often included in previous research. Consistent with our findings, Lewicki et al. conducted a study included 1836 patients who underwent CABG and identified that IABP was an independent predictor of new-onset AF after CABG \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. Inversely, Thoren et al. disagreed with this conclusion \u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e.It might be due to the fact that the majority of the operations (96%) were performed on-pump in their study cohort, which is dramatically different from ours.\u003c/p\u003e \u003cp\u003eNew-onset AF was clearly associated with more in-hospital complications. Similar to previous studies, we found patients with postoperative AF had higher risk of reoperation, re-intubation, postoperative myocardial infarction, stroke, renal failure, and in-hospital death \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e. However, we could not show any association between postoperative stroke and AF, which was supported by previous studies \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e. This might result from the fact that our study excluded patients who underwent concomitant valve surgery and only concentrated on in-hospital complications. To our best knowledge, previous studies of AF after CABG did not include re-entry into ICU and re-ICU time. From our study, we, firstly, demonstrated that the two variables above are all statistically significant between the two groups.\u003c/p\u003e \u003cp\u003eThis is a retrospective single center observational study. One of the major limitations is intrinsic to the observational nature of this study, which cannot adjust for unobserved or unknown confounders. Furthermore, the Chinese patient population might limit the generalizability of these reported findings. Finally, given the AF definition that the abnormal atrial originated rhythm be documented for at least 30\u0026nbsp;s, it is possible that the overall rate for AF occurrences may have been underreported.\u003c/p\u003e "},{"header":"Conclusions","content":" \u003cp\u003eIn summary, the present study found that the incidence of new-onset AF after OPCAB was 28.57%, which mainly occurred within the first 4 days after surgery. Age, peripheral vascular disease, cOPCAB, mechanical ventilation time, IABP use were independent predictors of new-onset AF after OPCAB. Patients with new-onset AF have significantly more in-hospital complications than those without AF.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study compiled with the Declaration of Helsinki and the study protocols were approved by the ethics committee of Peking university people\u0026rsquo;s hospital. Waiving the requirement for obtaining written informed consents was allowed by the ethics committee of Peking university people\u0026rsquo;s hospital, because the retrospective and observational nature of this study.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eAll data generated or analysed during this study are included in this published article and its supplementary information files.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;Not applicable.\u003c/p\u003e\n\u003cp\u003eAuthors' contributions\u003c/p\u003e\n\u003cp\u003eXu Hao performed the statistical analysis, data curation and writing the original draft；Fan Guangpu performed the data Curation；Chen Yu is in chargr og conceptualization, methodology and writing the editing.All authors read and approved the final manuscript\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e \u003cspan\u003eVidotti E, Vidotti L, Arruda TC, Ferraz E, Oliveira V, de Andrade AG, Cardoso J, Cardoso MH. Predicting postoperative atrial fibrillation after myocardial revascularization without cardiopulmonary bypass: A retrospective cohort study. J Card Surg. 2019;34(7):577\u0026ndash;82.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eTsai YT, Lai CH, Loh SH, Lin CY, Lin YC, Lee CY, Ke HY, Tsai CS. Assessment of the Risk Factors and Outcomes for Postoperative Atrial Fibrillation Patients Undergoing Isolated Coronary Artery Bypass Grafting. ACTA CARDIOL SIN. 2015;31(5):436\u0026ndash;43.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eFilardo G, Damiano RJ, Ailawadi G, Thourani VH, Pollock BD, Sass DM, Phan TK, Nguyen H, Da GB. Epidemiology of new-onset atrial fibrillation following coronary artery bypass graft surgery. HEART. 2018;104(12):985\u0026ndash;92.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eLin SZ, Crawford TC, Suarez-Pierre A, Magruder JT, Carter MV, Cameron DE, Whitman GJ, Lawton J, Baumgartner WA, Mandal K. A Novel Risk Score to Predict New Onset Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Grafting. HEART SURG FORUM. 2018;21(6):E489\u0026ndash;96.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eThoren E, Hellgren L, Stahle E. High incidence of atrial fibrillation after coronary surgery. Interact Cardiovasc Thorac Surg. 2016;22(2):176\u0026ndash;80.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eFarouk MA, Quan CZ, Xin LZ, Soni T, Dillon J, Hay YK, Nordin RB. A retrospective study on atrial fibrillation after coronary artery bypass grafting surgery at The National Heart Institute, Kuala Lumpur. F1000Res 2018, 7:164.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eChowdhury MA, Cook JM, Moukarbel GV, Ashtiani S, Schwann TA, Bonnell MR, Cooper CJ, Khouri SJ. Pre-operative right ventricular echocardiographic parameters associated with short-term outcomes and long-term mortality after CABG. Echo Res Pract. 2018;5(4):155\u0026ndash;66.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003ePollock BD, Filardo G, Da GB, Phan TK, Ailawadi G, Thourani V, Damiano RJ, Edgerton JR. Predicting New-Onset Post-Coronary Artery Bypass Graft Atrial Fibrillation With Existing Risk Scores. ANN THORAC SURG. 2018;105(1):115\u0026ndash;21.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eBenedetto U, Angelini GD, Caputo M, Feldman DN, Kim LK, Lau C, Di Franco A, Girardi LN, Gaudino M. Off- vs. on-pump coronary artery bypass graft surgery on hospital outcomes in 134,117 octogenarians. J THORAC DIS. 2017;9(12):5085\u0026ndash;92.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eClement KC, Alejo D, DiNatale J, Whitman G, Matthew TL, Clement SC, Lawton JS. Increased glucose variability is associated with atrial fibrillation after coronary artery bypass. J Card Surg. 2019;34(7):549\u0026ndash;54.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eAmar D, Zhang H, Leung DH, Roistacher N, Kadish AH. Older age is the strongest predictor of postoperative atrial fibrillation. ANESTHESIOLOGY. 2002;96(2):352\u0026ndash;6.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eParsaee M, Moradi B, Esmaeilzadeh M, Haghjoo M, Bakhshandeh H, Sari L. New onset atrial fibrillation after coronary artery bypasses grafting; an evaluation of mechanical left atrial function. ARCH IRAN MED. 2014;17(7):501\u0026ndash;6.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eKievisas M, Keturakis V, Vaitiekunas E, Dambrauskas L, Jankauskiene L, Kinduris S. Prognostic factors of atrial fibrillation following coronary artery bypass graft surgery. Gen Thorac Cardiovasc Surg. 2017;65(10):566\u0026ndash;74.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eIsmail MF, El-Mahrouk AF, Hamouda TH, Radwan H, Haneef A, Jamjoom AA. Factors influencing postoperative atrial fibrillation in patients undergoing on-pump coronary artery bypass grafting, single center experience. J CARDIOTHORAC SURG. 2017;12(1):40.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eLewicki L, Siebert J, Rogowski J. Atrial fibrillation following off-pump versus on-pump coronary artery bypass grafting: Incidence and risk factors. CARDIOL J. 2016;23(5):518\u0026ndash;23.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eMatsuo Y, Kumakura H, Kanai H, Iwasaki T, Ichikawa S. The Geriatric Nutritional Risk Index Predicts Long-Term Survival and Cardiovascular or Limb Events in Peripheral Arterial Disease. J ATHEROSCLER THROMB. 2020;27(2):134\u0026ndash;43.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eBanerjee A, Fowkes FG, Rothwell PM. Associations between peripheral artery disease and ischemic stroke: implications for primary and secondary prevention. STROKE. 2010;41(9):2102\u0026ndash;7.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eMurphy TP, Dhangana R, Pencina MJ, D'Agostino RS. Ankle-brachial index and cardiovascular risk prediction: an analysis of 11,594 individuals with 10-year follow-up. ATHEROSCLEROSIS. 2012;220(1):160\u0026ndash;7.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003ePollock BD, Filardo G, Da GB, Phan TK, Ailawadi G, Thourani V, Damiano RJ, Edgerton JR. Predicting New-Onset Post-Coronary Artery Bypass Graft Atrial Fibrillation With Existing Risk Scores. ANN THORAC SURG. 2018;105(1):115\u0026ndash;21.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eEfird JT, Jindal C, Kiser AC, Akhter SA, Crane PB, Kypson AP, Sverdlov AL, Davies SW, Kindell LC, Anderson EJ. Increased risk of atrial fibrillation among patients undergoing coronary artery bypass graft surgery while receiving nitrates and antiplatelet agents. J INT MED RES. 2018;46(8):3183\u0026ndash;94.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eThoren E, Hellgren L, Granath F, Horte LG, Stahle E. Postoperative atrial fibrillation predicts cause-specific late mortality after coronary surgery. SCAND CARDIOVASC J. 2014;48(2):71\u0026ndash;8.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eBoning A, Diegeler A, Hilker M, Zacher M, Reents W, Faerber G, Doenst T. Preoperative atrial fibrillation and outcome in patients undergoing on-pump or off-pump coronary bypass surgery: lessons learned from the GOPCABE trial. Interact Cardiovasc Thorac Surg. 2015;20(1):74\u0026ndash;8.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eFerreira AF, Moreira ASF, Pinho RJCR,JAM. P, P LA, F LA: Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting Surgery. Rev Port Cir Cardiotorac Vasc. 2017;24(3\u0026ndash;4):129.\u003c/span\u003e \u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"OPCAB；atrial fibrillation；predictors; complications","lastPublishedDoi":"10.21203/rs.3.rs-27299/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-27299/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Objective\n\nTo explore risk factors and in-hospital complications of new-onset atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB).\n\nMethods\n\nIn this study of 1344 patients who underwent isolated OPCAB from 2012 to 2015, patients were divided into AF and non-AF group according to whether new-onset postoperative AF occurred.\n\nResults\n\nThe incidence of new-onset AF after OPCAB was 28.57%, mainly appeared within the first 4 days after surgery. After binary logistic regression analysis, age, peripheral vascular disease, median-sternotomy OPCAB, mechanical ventilation time, IABP were independent predictors of AF( p \u003c0.001,OR 1.039,95%CI 1.023-1.055; p =0.007,OR 2.450,95%CI 1.282-4.684; p =0.044,OR 0.589,95%CI 0.351-0.987; p =0.013,OR 1.006,95%CI 1.001-1.011; p =0.007,OR 3.001,95%CI 1.356-6.642, respectively). Patients with AF have a significant higher risk of reoperation, re-entry into ICU, re-intubation, postoperative myocardial infarction, renal failure, and death ( p =0.013, p =0.015, p \u003c0.001, p =0.037, p \u003c0.001, p \u003c0.001, respectively), also a longer re-ICU time ( p =0.014).\n\nConclusion\n\nAdvanced age, peripheral vascular disease, median-sternotomy OPCAB, mechanical ventilation time, IABP were independent predictors for new-onset AF after OPCAB. Postoperative AF was clearly associated with more in-hospital complications.","manuscriptTitle":"New-Onset Atrial Fibrillation after Off-Pump Coronary Artery Bypass Grafting: Predictors and In-hospital Complications","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-05-11 21:39:15","doi":"10.21203/rs.3.rs-27299/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"cba4ef89-2874-42f5-849e-07fb40a51ce6","owner":[],"postedDate":"May 11th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":98186,"name":"Cardiac \u0026 Cardiovascular Systems"}],"tags":[],"updatedAt":"2020-06-04T11:23:14+00:00","versionOfRecord":[],"versionCreatedAt":"2020-05-11 21:39:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-27299","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-27299","identity":"rs-27299","version":["v1"]},"buildId":"ApUGefWb6u5IBVtyqm6d5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}