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The aortic knob index as a novel predictor of new-onset atrial fibrillation after off-pump coronary artery bypass grafting

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Abstract

Purpose

To validate the predictive value of the aortic knob index for identifying new-onset postoperative atrial fibrillation (POAF) after off-pump coronary artery bypass grafting (OPCAB).

Methods

Among 156 patients who underwent isolated OPCAB, 138 consecutive patients without a history of atrial fibrillation were enrolled in this retrospective observational cohort study. The patients were divided into two groups based on the development of POAF. We compared the baseline clinical characteristics; preoperative radiographic characteristics of the aorta, including aortic knob measurements; and perioperative data, between the groups. Logistic regression analysis was performed to identify the predictors of new-onset POAF.

Results

New-onset POAF developed in 35 (25.4%) patients. Multivariate logistic regression analysis revealed that the aortic knob index was an independent predictor of POAF and yielded that the risk of POAF increased by 1.85 times when the aortic knob index increased by 0.1 (odds ratio, 1.853; confidence interval, 1.326–2.588; P < 0.001). Receiver operating characteristic analysis revealed that an aortic knob index of 1.364 constituted a cutoff value for new-onset POAF with 80.0% sensitivity and 65.0% specificity.

Conclusions

The aortic knob index on preoperative chest radiography was a significant and independent predictor of new-onset POAF following OPCAB.

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Data availability

The data underlying this article are available from the corresponding author upon reasonable request.

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Funding

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, Wakayama, 647-0072, Japan

    Naoki Yamamoto & Koji Onoda

Authors
  1. Naoki Yamamoto
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  2. Koji Onoda
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Contributions

NY conceived of the present idea and wrote the manuscript. NY and KO designed, conducted the study and contributed to data collection. All the authors discussed the results and approved the final manuscript.

Corresponding author

Correspondence to Naoki Yamamoto.

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Yamamoto, N., Onoda, K. The aortic knob index as a novel predictor of new-onset atrial fibrillation after off-pump coronary artery bypass grafting. Surg Today 54, 168–176 (2024). https://doi.org/10.1007/s00595-023-02717-6

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  • DOI: https://doi.org/10.1007/s00595-023-02717-6

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