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Thorac Cardiovasc Surg 2014; 62(07): 561-568
DOI: 10.1055/s-0034-1372349
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

The Influence of the Metabolic Syndrome on Atrial Fibrillation Occurrence and Outcome after Coronary Bypass Surgery: A 3-Year Follow-up Study

Branislava Ivanovic
1   Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia
2   Medical Faculty, University of Belgrade, Belgrade, Serbia
,
Marijana Tadic
3   Department of Cardiology, University Clinical Hospital Centre “Dr Dragisa Misovic,” Belgrade, Serbia
,
Zeljko Bradic
4   Department of Anesthesiology, Clinical Centre of Serbia, Belgrade, Serbia
,
Nevenka Zivkovic
1   Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia
,
Dejana Stanisavljevic
2   Medical Faculty, University of Belgrade, Belgrade, Serbia
5   Institute for Medical Statistics and Informatics, Medical Faculty, University of Belgrade, Belgrade, Serbia
,
Vera Celic
2   Medical Faculty, University of Belgrade, Belgrade, Serbia
3   Department of Cardiology, University Clinical Hospital Centre “Dr Dragisa Misovic,” Belgrade, Serbia
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Publikationsverlauf

18. Dezember 2013

08. Februar 2014

Publikationsdatum:
21. April 2014 (online)

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Abstract

Background We sought to investigate the influence of the metabolic syndrome (MS) on new-onset postoperative atrial fibrillation (POAF), and occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) in a period of 3 years after isolated coronary artery bypass grafting (CABG) surgery.

Methodology The study included 460 patients who underwent the first CABG operation without baseline atrial fibrillation. The MS was defined by the presence of three or more Adult Treatment Panel (ATP)–American Heart Association (AHA)– National Heart, Lung, and Blood (NHLB) Institute criteria. POAF was diagnosed by continuous electrocardiographic monitoring during the first 48 to 72 hours after CABG. All the patients were followed up for at least 3 years after surgery.

Results The MS and its criteria were significantly associated with POAF and MACCE occurrence in the 3-year period after isolated CABG surgery. Among the MS risk factors, hypertension, abdominal obesity, and the increased fasting glucose level were independently associated with both POAF and MACCE onset in the observed patients. Individuals with four or five MS criteria have similar risk of POAF or MACCE as individuals with three MS criteria. In the 3-year period of follow-up, the MS was proven to be associated with MACCE occurrence, independently of hypertension, diabetes, and obesity defined by body mass index.

Conclusions The MS and its criteria significantly increased risk of POAF and MACCE in a 3-year period. The MS, irrespective of hypertension, diabetes, and obesity, was associated with POAF and MACCE in the patients who underwent CABG.

Keywords

atrial fibrillation - metabolic syndrome - coronary artery bypass grafting - hypertension - diabetes