ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Usefulness of CHA2DS2-VASc scoring system in predicting atrial fibrillation after coronary artery bypass grafting
Kemalettin Erdem1, Mehmet Yazıcı2, Serkan Öztürk2, Anıl Avcı3, Yeliz Güler4, Fatma Hızal Erdem2, Bahadır Dağlar1, Hızır Mete Alp4, İbrahim Dönmez2, Ali Metin Esen3
1Departments of Cardiovascular Surgery, Medical Faculty of Abant İzzet Baysal University, Bolu, Turkey
2Departments of Cardiology, Medical Faculty of Abant İzzet Baysal University, Bolu, Turkey
3Departments of Cardiology, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey
4Departments of Cardiovascular Surgery, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2016.11751
Background: This study aims to assess whether CHADS2 and CHA2DS2-VASc scoring systems are useful in predicting atrial fibrillation after coronary artery bypass grafting.

Methods: Between January 2010 and July 2013, a total of 478 patients (305 males, 173 females; mean age 62.1 years; range 40 to 83 years) who underwent coronary artery bypass grafting in our clinic were enrolled in the study. Data were obtained from the medical files of the patients and hospital records. All patients were monitored in the intensive care unit after surgery. Atrial fibrillation lasting more than 30 seconds in irregular rhythm without P waves on telemetry was classified as postoperative atrial fibrillation. All patients were evaluated using CHADS2 and CHA2DS2-VASc scoring systems.

Results: Of 478 patients, 102 had postoperative atrial fibrillation. CHADS2 and CHA2DS2-VASc scores were statistically significantly higher in patients with postoperative atrial fibrillation than others (2.1±0.8 vs 1.1±0.8, p<0.001 and 4.3±1.1 vs 2.2±1.1, p<0.001). Age, left atrial diameter, left ventricular ejection fraction, and CHA2DS2-VASc scores were independently associated with postoperative atrial fibrillation. A CHA2DS2-VASc score of ≥2 predicted postoperative AF with %96.3 sensitivity and %74.6 specificity (AUC=0.906, 95% CI=0.875-0.938, p<0.001).

Conclusion: The CHA2DS2-VASc score is a strong predictor of atrial fibrillation development after isolated coronary artery bypass grafting surgery. Therefore, the CHA2DS2-VASc scoring system can be used as a stratification tool to estimate atrial fibrillation after coronary artery bypass grafting.

Keywords : CHA2DS2-VASc scoring system; coronary artery bypass grafting; postoperative atrial fibrillation
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