Vol 80, No 10 (2022)
Letter to the Editor
Published online: 2022-07-18

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New‐onset postoperative atrial fibrillation after coronary artery bypass graft surgery. Authors’ reply

Anna Smukowska-Gorynia1, Bartłomiej Perek2, Marek Jemielity2, Anna Olasińska-Wiśniewska2, Justyna Marcinkowska3, Sebastian Stefaniak2, Artur Cieślewicz4, Sylwia Iwańczyk1, Maciej Lesiak1, Tatiana Mularek-Kubzdela1
Pubmed: 35844132
Kardiol Pol 2022;80(10):1062-1063.

Abstract

Not available

LETTER TO THE EDITOR

New-onset postoperative atrial fibrillation after coronary artery bypass graft surgery. Authors’ reply

Anna Smukowska-Gorynia1Bartłomiej Perek2Marek Jemielity2Anna Olasińska-Wiśniewska2Justyna Marcinkowska3Sebastian Stefaniak2Artur Cieślewicz4Sylwia Iwańczyk1Maciej Lesiak1Tatiana Mularek-Kubzdela1
11st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
2Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
3Department of Statistical Analyses and Computed Sciences, Poznan University of Medical Sciences, Poznań, Poland
4Department of Clinical Pharmacology, Poznan University of Medical Sciences, Poznań, Poland

Correspondence to:

Anna Smukowska-Gorynia, MD, PhD,

1st Department of Cardiology,

Poznan University of Medical Sciences,

Długa 1/2, 61–848 Poznań, Poland,

phone: +48 618 549 505,

e-mail: aniasmuk@wp.pl

Copyright by the Author(s), 2022

DOI: 10.33963/KP.a2022.0143

Received: July 17, 2022

Accepted: July 18, 2022

Early publication date: July 18, 2022

Referring to the letter from Engin et al. [1], we would first like to thank the authors for their interest in our manuscript. We are grateful for all words of appreciation, as well as interesting observations and questions.

Our study concerned new-onset postoperative atrial fibrillation (POAF) following elective coronary artery bypass graft surgery (CABG), hence patients with a history of atrial fibrillation were excluded. However, the exclusion criteria were based on medical records, and a 12-lead electrocardiogram and 24-hour heart rhythm monitoring were available immediately after surgery. We assumed that the probability of a new atrial fibrillation episode between admission and the surgery would be negligible.

The issue of functional thyroid disorders is well known to us, therefore, all patients with a history of hypothyroidism had to be euthyroid and adequately treated with triiodothyronine replacement [2]. Moreover, in our study, a history of hypothyroidism did not differentiate patients with POAF from patients without POAF [3]. Only patients currently being treated for hyperthyroidism were excluded from the study to avoid its influence on the development of POAF.

As we stated in the introduction, the study was designed to determine whether the preoperative or postoperative neopterin concentration was a better prognostic factor in POAF. Since neopterin was first evaluated as a predictive factor in POAF, we decided to test it before surgery and at two-time points after surgery, and, indeed, we also investigated its association with a possible recurrence of POAF.

Finally, there is the question of multivariable statistical models. One of the limitations of our study was the number of patients, which then limited the examination of all factors in one model. Therefore, we decided to divide many statistically significant potential predictors into three groups: preoperative, surgical, and echocardiographic. According to these analyses, apart from the higher preoperative concentration of neopterin, important factors were also: higher body mass index (BMI, kg/m2), history of pulmonary disease, increased diastolic thickness of interventricular septum, and duration of operation [3].

Article information

Conflict of interest: None declared.

Funding: None.

Open access: This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. For commercial use, please contact the journal office at kardiologiapolska@ptkardio.pl.

References:

  1. Engin M, Aydın U, Deveci G. New-onset postoperative atrial fibrillation after coronary artery bypass graft surgery. Kardiol Pol. 2022; 80(10): 10601061, doi: 10.33963/KP.a2022.0149 , indexed in Pubmed: 35724338.
  2. Zhao D, Xu F, Yuan X, et al. Impact of subclinical hypothyroidism on outcomes of coronary bypass surgery. J Card Surg. 2021; 36(4): 14311438, doi: 10.1111/jocs.15395, indexed in Pubmed: 33567099.
  3. Smukowska-Gorynia A, Perek B, Jemielity M, et al. Neopterin as a predictive biomarker of postoperative atrial fibrillation following coronary artery bypass grafting. Kardiol Pol. 2022 [Epub ahead of print], doi: 10.33963/KP.a2022.0143, indexed in Pubmed: 35698968.



Polish Heart Journal (Kardiologia Polska)