Risk Factors and Intervention Measures for New Onset Atrial Fibrillation in Patients with Coronary Heart Disease After OPCABG Surgery
Objective To investigate the risk factors of new onset atrial fibrillation after off-pump coronary artery bypass grafting(OPCABG)in patients with coronary heart disease and establish a logistic regression model to analyze the predictive value of the model for new onset atrial fibrillation after OPCABG,so as to provide reference for clinical intervention.Methods A total of 175 patients with coronary heart disease in Henan Provincial Chest Hospital from October 2021 to August 2023 were selected,and they were divided into the occurrence group(49 cases)and the non occurrence group(126 cases)according to whether new atrial fibrillation occurred 5 days after OPCABG.The clinical data of the two groups were compared,and the influencing factors of postoperative new onset atrial fibrillation were analyzed by multivariate logistic regression,and the logistic regression model was established.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model for postoperative new onset atrial fibrillation,Hosmer-Lemeshow was used to evaluate the fitting degree of the model,and the decision curve was used to evaluate the clinical net return rate of the model.Results Left atrial volume index,postoperative intra-aortic balloon counterpulsation(IABP)assistance,stenosis of the proximal segment of the right coronary artery ≥75％,and preoperative neutrophil-to-lymphocyte ratio(NLR)and serum growth differentiation factor 15(GDF-15)were independent risk factors for new-onset atrial fibrillation after surgery(P＜0.05).The AUC of the logistic regression model for predicting new-onset atrial fibrillation after surgery was 0.928,with sensitivity and specificity of 89.80％and 85.71％,respectively,and good calibration ability.Conclusion Left atrial volume index,postoperative IABP assistance,stenosis of the proximal segment of the right coronary artery ≥75％,preoperative NLR,and serum GDF-15 are independent risk factors for new-onset atrial fibrillation after OPCABG in patients with coronary heart disease.Based on these factors,a logistic regression model was established,which has certain predictive value for new-onset atrial fibrillation after surgery.Clinicians can use this model to screen high-risk populations and take active intervention measures to reduce the risk of new-onset atrial fibrillation after surgery.
万方数据
维普
