Table 1. Basic characteristics of the 35 cohorts included in the meta-analysis.
| Author, publication year, country | Source of participants | Cases/N | Mean age (years), male (%) | Study design | Method of AF Detection | BMI Data Reported | Type of operation | Adjustment for confounders |
|---|---|---|---|---|---|---|---|---|
| Alam, 2011, USA | St. Luke’s Episcopal Hospital/Texas Heart Institute | 2867/13115 | 63.3, 54.4 | Retrospective cohort study | ECG, treating physician | <30 ≥30 |
CABG | Age, sex, preoperative morbidity, extent of CAD, No. of CABG, use of internal mammary artery, total circulatory bypass time, ACT. |
| Bramer, 2011, Netherlands | Catharina Hospital | 2517/9348 | 64.2, 72.6 | Prospective cohort study | ECG, | Continuous variable | CABG or valve surgery |
Age, BSA, COPD, PVD, prior stroke, prior MI, LVEF, creatinine, type of procedure, ECC duration, transfusion of RBCs, FFP and platelets, and reoperation for bleeding. |
| Brandt, 2001, Germany | University Hospital Kiel | 207/500 | 63, 82 | Retrospective cohort study | NA | <30 ≥30 |
CABG | Sex, history of prior MI, COPD, previous stroke, duration of CPB, ACT and number of distal anastomoses performed. |
| Banach (aortic stenosis), 2007, Poland | Department of Cardiac Surgery in Lodz | 62/150 | 63.3, 48.7 | Retrospective cohort study | ECG, | ≤21 ≥30 |
valve surgery | Age, BMI, pre-operative and post- operative LVEF, mitral regurgitation. |
| Engelman, 1999, USA | Brigham and Women’s Hospital | 1518/5168 | 67, 68 | Retrospective cohort study | NA | <20 20–30 >30 |
CABG or valve surgery |
Age, sex, EF, NYHA functional class, previous cardiac operation, pre-operative diabetes, peripheral and cerebral vascular disease, hypertension, renal failure, CHF, MI, COPD, smoking, urgency of operation, use of an ITA, and type of operation. |
| Bidar, 2014, Netherlands | Maastricht University Medical Centre | 73/148 | 67.1,80.6 | Prospective cohort study | ECG | Continuous variable | CABG or valve surgery |
Sex, DM, baseline CRP, smoke, early POAF, aortic clamp time, creatinine levels |
| Echahidi, 2014, Canada | The Quebec Heart Institute | 1370/5086 | 64.1, 76.5 | Retrospective cohort study | ECG | <25 25–30 30–35 ≥35 Continuous variable |
CABG | Age, gender, BMI, DM, left main coronary stenosis, preoperative medication with β-blockers, and ACT. |
| Engin, 2020, Turkey | Bursa Yüksek İhtisas Training and Research Hospital |
55/199 | 58.2, 80.4 | Prospective cohort study | ECG | Continuous variable (Visceral Adiposity Index) | CABG | Age, Hypertension, COPD, Triglyceride Lymphocyte, CRP, prognostic nutritional index; |
| El-Chami, 2012, USA | Emory University Hospital or Emory Crawford Long Hospital | 3486/18517 | 62.5, 71.7 | Retrospective cohort study | NA | NA | CABG | Age, race, gender, height, weight, BMI, body surface area, last creatinine level, angina, left main CAD, immunosuppressive therapy, preoperative insertion of an intra-aortic balloon pump, number of diseased vessels and preexisting medical conditions. |
| Erdil N, 2013, Turkey | Inonu University, School of Medicine | 129/1040 | 60.2, 75.8 | Retrospective cohort study | ECG, physician assessment | Continuous variable | CABG | Age, additive EuroSCORE score, and prolonged ventilation. |
| Efird (Black), 2016, USA | East Carolina Heart Institute | 376/2329 | NA, 58.1 | Retrospective cohort study | Medical record | <18.5 18.5–25 25–30 30- 35 35- 40 ≥40 |
CABG | Age, sex, DM, unstable heart failure, hypertension, PAD, three-vessel disease. |
| Efird (White), 2016, USA | East Carolina Heart Institute | 2627/11265 | NA, 72.8 | Retrospective cohort study | Medical record | <18.5 18.5–25 25–30 30–35 35–40 ≥40 |
CABG | Age, sex, DM, Unstable heart failure, hypertension, PAD, Three-vessel disease. |
| Gao, 2016, China | First Affiliated Hospital of Nanjing Medical University | 1183/4740 | 63.6, 68.7 | Retrospective cohort study | NA | <18.5 18.5–25 25–30 30–35 35–40 ≥40 |
Valve surgery | Age, gender, surgery type, family history of CAD, diabetes, hypertension, heart failure and lipid lowering medication. |
| Ghanta, 2017, USA | Regional Society of Thoracic Surgeons certified database | 3052/13637 | 65.6, 70.7 | Retrospective cohort study | Medical records | 18.5–30 30 ≤ BMI ≤40 >40 |
CABG and/or valve surgery | STS PROM, age, sex, presence of hypertension, DM, renal failure, and heart failure. |
| Girerd, 2009, Canada | Quebec Heart Institute | 433/2214 | 56.2, 100 | Nested case–control | ECG | <25 25–30 30–35 35–40 ≥40 |
CABG | Waist circumference and age. |
| Gürbüz, 2014, Turkey | Medicana International Ankara Hospital | 139/790 | 62, 77.8 | Retrospective cohort study | ECG | ≤ 30 >30 |
CABG | Age, sex, DM, hypertension, hyperlipidemia, preoperative arrhythmia and atrial fibrillation, PAD, history of cerebrovascular disease, preoperative echocardiography data, history of clopidogrel use, operation type, CPB and cross clamp times, number of grafts, extubation time, intensive care unit and hospital length of stay times, amount of drainage, number of used blood and blood products, postoperative creatinine and creatinine kinase levels, occurrence of postoperative arrhythmia and stroke. |
| Hakala, 2002, Finland | Kuopio University Hospital | 30/92 | 61.7, 76 | Prospective cohort study | ECG | Continuous variable | CABG | Age, preoperative haemoglobin, diabetes, HRV measurements. |
| Ivanovic (MS), 2014, Serbia | Clinical Center of Serbia | 103/477 | 60, 71 | Retrospective cohort study | ECG | ≤ 30 >30 |
CABG | Age, gender. |
| Kitahara, 2017, USA | University of Chicago Medicine, | 119/486 | 65/33.7 | Retrospective cohort study | NA | <24.9 25–29.9 30–34.9 ≥35 |
cardiac surgery | Sex, height, weight, dyslipidemia, hypertension, DM, chronic renal failure, renal failure on dialysis, COPD, EF. |
| Kuduvallia, 2002, UK | Cardiothoracic Centre-Liverpool. | 1155/4713 | 62, 79 | Prospectively cohort study | ECG | <30 30–35 >35 |
CABG | Age, sex, previous cardiac surgery, LVEF, left main stem stenosis, number of major coronary arteries with stenosis >70%, priority of surgery, peripheral vascular disease, DM, renal dysfunction, and respiratory disease. |
| Lee, 2018, South Korea | Tertiary hospital in Seoul |
244/999 | 65.4, 75.3 | Retrospective cohort study | ECG | <25 >25 |
CABG | Age, Acute coronary syndrome, hypertension, ejection fraction, on pump, Post operation electrolyte Potassium: Potassium, numeral rating scale |
| Melduni, 2011, USA | Olmsted County, Minnesota | 135/351 | 66.7, 67.2 | Prospectivey cohort study | Medical records | Continuous variable | Cardiac Surgery | Age, BMI, hypertension, mitral regurgitation, diastolic function, type of operation, and perfusion time. |
| Moulton, 1996, USA | Barnes Hospital | 833/2299 | 62.8, 65.1 | Retrospective cohort study | NA | ≤30 >30 |
CABG | Age, sex, race, history of reoperation, CHF, prior MI, renal failure, DM, hypertension, COPD or stroke, CPB, aortic cross-clamp. |
| Omer, 2016, USA | Veterans Affairs hospital | 215/1248 | 62.4, 99 | Retrospective cohort study | ECG | <25 25–30 ≥30 |
CABG | Age, a history of hypertension, obesity, DM, inflammation, and longer pump and cross-clamp times. |
| Pan, 2006 USA |
Texas Heart Institute, St. Luke’s Episcopal Hospital, | 1913/9862 | 62.9, 75.4 | Retrospective cohort study | NA | 20–24.9 25–29.9 30–34.9 35–39.9 ≥40 |
CABG | Age, sex, hypertension, pulmonary disease, hyperlipidemia, DM, total bypasstime, β-Blocker, antiarrhythmics, EF, triple-vessel CAD, left main CAD, renal insufficiency. |
| Perrier, 2016, France | University Hospital of Strasbourg | 311/1481 | 65.2, 81.2 | Prospectivey cohort study | ECG | ≤ 35 >35 |
CABG | Age, eGFR<60 ml/min, PAD, anti-platelet treatment, CHA2DS2-VASC score, β-blockers |
| Reeves, 2003, UK | Patient Analysis & Tracking System, Dendrite Clinical Systems |
675/4372 | NA, 81.1 | Prospectivey cohort study | ECG | <25 25–30 30–35 ≥35 |
CABG | age, Parsonnet score, number of grafts, blood loss; red blood cell, platelet, fresh frozen plasma transfusion; postoperative hemoglobin levels; duration of ventilation, ICU stay, combined ICU and HDU stay, and total postoperative stay |
| Stamou, 2011, USA | Sanger Heart and Vascular Institute | 600/2440 | 62.5, 73.3 | Retrospective cohort study | NA | 18.5–24.9 25–29.9 ≥30 |
CABG or valve surgery |
Propensity scores. |
| Stefàno, 2020, Italy | Tertiary hospital in Florence | 127/249 | 65.4, 77.3 | Retrospective cohort study | ECG | Continuous variable | CABG or valve surgery |
Age, ACEI, statins, operation time, total clamp time, cardiopulmonary bypass time, presence of pericardial/pleural effusion, arterial hypertension, plasmatic creatinine |
| Sun, 2011, USA | Washington Hospital Center | 3462/12367 | 64.3, 71 | Retrospective cohort study | ECG | <18.5 18.5–25 25–30 30–40 ≥40 |
CABG | Age, sex, Race, HF, Left main coronary artery stenosis, Ventricular arrhythmias, Preop angina, OSA, DM, Hypertension, Family history of CAD, Previous stroke, Hypercholesterolemia, Hemodialysis, Current smoker, β-blockers, ACEI, Lipid-lowering drugs. |
| Tosello, 2015, France | Cardiac Surgery Unit of the Hopital Europeen G | 36/176 | 70.5, 67.6 | Prospective cohort study | ECG | Continuous variable | BAVR | Age, sex, weight, heihgt, smoking, DM, CKD, COPD, CAD, PVD, β-blocker, amiodarone, LVEF<50%, extracorporeal circulation, aortic cross-clamp time, transfusion in ICU, EUROSCORE >10 |
| Tadic M, 2011, Serbia | Clinical Center of Serbia | 72/322 | 59.9, 71.7 | Retrospective cohortstudy | ECG | <30 ≥ 30 |
CABG | Age, hypertension, DM, obesity, hypercholesterolemia, leukocytosis, and segmental kinetic disturbances of the left ventricle. |
| Wong, 2015, USA | Stanford University School of Medicine | 226/545 | 66.2, 57.2 | Retrospective cohort study | ECG | Continuous variable | CABG, AVR, MVR | Age, sex, previous AF, smoking status, elective status, IABP, COPD, history of cerebral vascular event, surgery |
| Yap, 2007, Australia | St Vincent’s Hospital and The Gee long Hospital | 1425/3968 | 66.4, 73 | Retrospective cohort study | NA | 20–30 30–40 ≥40 |
CABG and valve surgery |
Age, sex, DM, hypercholesterolemia, renal impairment (Cr >0.2 mmol/L), preoperative dialysis, hypertension, cere brovascular disease, PVD, COAD, NYHA class IV, severe LV impairment (ejection fraction <30%), mean PA pressure, emergency status and CPB time. |
| Zacharias, 2005, USA | Saint Vincent Mercy Medical Center and Saint Luke’s Hospital | 1496/6749 | NA | Retrospective cohort study | ECG, physician findings, hospital or physician chart notes and discharge summaries | <22 22–25 25–30 30–35 35–40 ≥40 Continuous variable |
CABG or valve surgery | Age, gender, white race, current smoker, DM, hypertension, PRF, COPD, PVD, MI, CHF, angina , arrhythmia , preoperative medications, triple-vessel disease, LMD, emergency surgery, mitral valve surgery, aortic valve surgery, off-pump, perfusion time, cross-clamp time, and IABP. |
Notes.
Abbreviation
- ECG
- electrocardiograph
- CABG
- coronary artery bypass grafting
- CAD
- coronary artery disease
- ACT
- aortic clamp time
- BSA
- body surface area
- COPD
- chronic obstructive pulmonary disease
- PVD
- peripheral vascular disease
- MI
- myocardial infarction
- LVEF
- left ventricular ejection fraction
- ECC
- extra corporal circulation
- RBC
- red blood cell
- FFP
- fresh frozen plasma
- CPB
- cardiopulmonary bypass
- EF
- ejection fraction
- NYHA
- New York Heart Association
- CHF
- congestive heart failure
- ITA
- internal thoracic artery
- BMI
- body mass idex
- DM
- diabetes mellitus
- PAD
- peripheral artery disease
- STS
- society of thoracic surgeons
- PROM
- predicted risk of operative mortality
- HRV
- heart rate variability
- EF
- ejection fraction
- eGFR
- Estimated Glomerular Filtration Rate
- ICU
- intensive care unit
- HDU
- high dependency unit
- HF
- heart failure
- ACEI
- Angiotensin-Converting Enzyme Inhibit
- CKD
- chronic kidney disease
- PVD
- peripheral vascular disease
- PA
- peripheral artery
- PRF
- preoperative renal failure
- LMD
- left main disease
- IABP
- intra-aortic balloon pump
- DM
- diabetes mellitus