Role of red blood cell distribution width and epicardial fat in atrial fibrillation after cardiopulmonary bypass

Abstract

Objective:Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, and it remains a challenge for cardiac surgeons despite advances in medicine. A number of studies have been performed to examine various parameters to predict which patients will develop POAF. The present study was performed to investigate the roles of epicardial adipose tissue (EAT) volume and red blood cell distribution width (RDW) as predictors of POAF.Methods:The medical records of 350 patients undergoing coronary artery bypass grafting in one or more vessels at the Tertiary Cardiac Center, Cardiovascular Surgery Department, Mevlana (Rumi) University Private Hospital (Konya, Turkey), were screened between December 2011 and May 2015. The study population consisted of 149 patients fulfilling the inclusion criteria and undergoing a preoperative evaluation by computed chest tomography. All patient demographics and laboratory parameters were obtained from medical records.Results:Age, postoperative RDW, and tomography variables, including the left atrial (LA) volume, LA diameters, and EAT volume, were significantly higher while the hemoglobin level and hematocrit were significantly lower in patients developing atrial fibrillation after cardiopulmonary bypass. A logistic multivariate regression analysis was performed on age, postoperative RDW, and tomography variables, including LA volume, LA diameters and EAT volume. Only age (OR 1.0731, 95% CI 1.012–1.138; p = 0.018) was an independent predictor of the development of POAF.Conclusions:Although the EAT volume was high in patients developing atrial fibrillation after surgery, age was the only significant predictor of POAF on multivariate analysis. Additional studies regarding the predictive roles of epicardial fat and RDW in POAF are needed.