Risk factors for new-onset atrial fibrillation after off-pump coronary artery bypass grafting:A systematic review and meta-analysis
Objective To systematically evaluate the risk factors for new-onset atrial fibrillation after off-pump coronary artery bypass grafting(OPCABG).Methods PubMed,EMbase,The Cochrane Library,CNKI,Wanfang,VIP,SinoMed were searched to collect published literature on risk factors for new-onset atrial fibrillation after OPCABG from inception to September 2022.Two authors independently screened,extracted data and evaluated the quality.The Newcastle-Ottawa Scale(NOS)was used to evaluate the quality of the included studies,and Stata 12.0 and RevMan 5.4 softwares were used for meta-analysis.Results A total of 18 researches were included,including 6 354 patients of OPCABG.The NOS scores of the included studies were 6-8 points.Meta-analysis showed that age[MD=2.56,95％CI(1.61,3.52),P＜0.001],hypertension[OR=1.77,95％CI(1.18,2.66),P＜0.001],EuroSCORE Ⅱ score[MD=0.70,95％CI(0.34,1.06),P＜0.001],frequent atrial premature beats or atrial tachycardia[OR=3.77,95％CI(2.13,6.68),P＜0.001],left atrium diameter(LAD)[MD=1.64,95％CI(0.26,3.03),P=0.010],left ventricular ejection fraction(LVEF)[MD=-1.84,95％CI(-2.85,-0.83),P＜0.001],right coronary stenosis[OR=2.49,95％CI(1.29,4.81),P=0.006],three-vessel coronary artery lesions[OR=0.73,95％CI(0.54,0.97),P=0.030],not using β blockers[OR=0.81,95％CI(0.69,0.96),P=0.010],operation time[MD=10.13,95％CI(8.15,12.10),P＜0.001],duration of mechanical ventilation[OR=2.85,95％CI(1.79,3.91),P＜0.001]were risk factors for new-onset atrial fibrillation after OPCABG.Conclusion Advanced age,hypertension,high EuroSCORE Ⅱ score,frequent atrial premature beats or atrial tachycardia,increased LAD,decreased LVEF,right coronary stenosis,three-vessel coronary artery lesions,not using β blockers,prolonged operation time and mechanical ventilation are risk factors for new-onset atrial fibrillation after OPCABG.Due to factors such as the methodology,content and quality of the included literature,the conclusion of this study need to be supported by more high-quality studies.
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