Background: The aim of this study was to determine the incidence and predictors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) and also, to investigate the effect of β-blocker plus statin use on post-CABG AF.

Methods: Between September 2003 and April 2004, 121 consecutive patients (99 males, 22 females; mean age 61.2±7.5 years; range 39 to 78 years) undergoing elective CABG surgery were included to the study. The patients were divided into two groups according to the absence [group-SR (sinus ryhtym), n=92] or presence [group-AF, n=29] of post- CABG AF. Variables were compared by Fischer’s exact test, chi-square and independent samples t-test. Multivariate logistic regression analysis was used for independent predictors of post-CABG AF.

Results: Post-CABG AF was detected in 23.9%. Mean age (66.6±7.2 vs 59.4±7.9, p=0.0001) and the incidence of chronic obstructive pulmonary disease (13.8 vs 2.2%, p=0.012) were higher in group-AF. The patient is older than 63 years of age (41.3 vs 13.3%, p=0.0001, area under the ROC curve of 0.748) have an increased prevalance of post-CABG AF. Much more frequent occurrence of post-CABG AF was in the patients without using β-blocker drug (40% vs 19.8%, p=0.035). Post-CABG AF was lower in the patients receiving statin than the patients not receiving statin (15.9% vs 34.6%, p=0.017). Post-CABG AF was lower in the patients receiving β-blocker plus statin therapy (13.3 vs 43.8%, p=0.015) than the patients not receiving these drugs. White blood cell (WBC) count of the patients receiving statin were lower than the patients not receiving statin (10618±3540 vs 13038±5661, p=0.005) in postoperative day 2 (POD 2). Chest tube drainage (1048.6±776.2 vs 641.5±514.6, p=0.001), and WBC count (13210±5550 vs 11160±4320, p=0.041), serum BUN (33.8±32.5 vs 21.6±13, p=0.004) in POD 2 were higher in group-AF. Intensive care unit stay (69.8±47.1 vs 53.6±19.2, p=0.008) and lenght of stay (LOS>7 days, 58.6 vs 37%, p=0.039) were higher in group-AF. Advanced age (OR=1.099, p=0.018) and increased postoperative drainage (OR=1.001, p=0.045) were independent predictors of post-CABG AF.

Conclusions: Age and postoperative blood loss are independent predictors of post-CABG AF. β-blocker plus statin therapy seems to be the best medication of choice on reducing the incidence of post-CABG AF. However, new prospective studies about the efficacy of this combination therapy are required.

Keywords : Adrenergic beta-antagonists; atrial fibrillation/etiology; coronary artery bypass