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Biochemical Predictors of New-Onset Atrial Fibrillation after Ascending Aorta Replacement Surgery in Acute Type A Aortic Dissection Patients

Jian Shi, Yong-Qing Cheng, Xi-Yu Zhu, Ze-Yi Zhou, Yi Jiang, Yun-Xing Xue, Hai-Long Cao, Dong-Jin Wang

JOURNAL OF CARDIAC SURGERY(2023)

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Abstract
Objective. This study aimed to determine the risk factors of new-onset postoperative atrial fibrillation after ascending aortic replacement in acute type A aortic dissection patients, with emphasis on biochemical parameters. Methods. From Jan 2020 to Dec 2021, a total of 435 acute type A aortic dissection patients who underwent ascending aortic replacement and without a history of atrial fibrillation were retrospectively analyzed in this study. Perioperative data of these patients were obtained from the hospital's database. The 30-day follow-up was via telephone interviews. The multivariate regression analysis was used to identify risk factors that may be predictive of postoperative atrial fibrillation. Results. 218 (50.1%) patients experienced postoperative atrial fibrillation after ascending aorta replacement surgery. Older age (OR = 1.081 (1.059-1.104), p < 0.001), higher total bile acid (OR = 1.064 (1.024-1.106), p = 0.002), glucose (OR = 1.180 (1.038-1.342), p = 0.012), and serum potassium (OR = 2.313 (1.078-4.960), p = 0.031) were identified by multivariate regression analysis as risk factors of postoperative atrial fibrillation. The multivariate regression analysis prediction model incorporating these four factors had a good prediction effect (AUC = 0.769 (0.723-0.816), p < 0.001). Conclusions. Older age, higher total bile acid, glucose, and serum potassium were risk factors of postoperative atrial fibrillation after ascending aortic replacement surgery in acute type A aortic dissection patients.
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Key words
atrial fibrillation,aorta replacement surgery,new-onset
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