Search

Objective: An increasing number of studies suggest that sleep disordered breathing (SDB) may be associated with postoperative atrial fibrillation (POAF), but these studies present discrepant results. Thus, this meta-analysis aimed to synthesize the data associating SDB with POAF in patients who underwent cardiac surgery. Methods: A literature search was performed in the Scopus, PubMed, Web of Science, EMBASE, CENTRAL, Weipu, Wanfang Data, and China National Knowledge Infrastructure databases before August 2022. Data were extracted, and the strength of the relationship between SDB and the risk of POAF was evaluated using odds ratio (OR) and 95% confidence intervals (CIs). All statistical analysis was carried out using the Stata 12.0 software. Results: A total of 24 studies with 660,685 subjects were included in current meta-analysis. SDB was significantly associated with the risk of POAF in the patients who underwent cardiac surgery (OR = 1.49; 95% CI, 1.30–1.70; p <.001). Next subgroup analysis revealed that such association may be increased in the group with medical equipment-measured SDB (OR = 2.27; 95% CI, 1.59–3.23; p <.001), prospective studies (OR = 2.17; 95% CI, 1.55–3.03; p <.001), patients without a previous history of atrial fibrillation (OR = 2.04; 95% CI, 1.47–2.82; p <.001), and patients who received a coronary artery bypass graft (OR = 2.10; 95% CI, 1.45–3.05; p <.001). No publication bias was identified. Conclusion: The results of meta-analysis support that SDB may be associated with an increased risk of POAF in patients who had undergone cardiac surgery, and these results should be confirmed in more rigorously designed studies. Patients with SDB who underwent cardiac surgery showed increased risk of POAF. The relationship between SDB and POAF should be explained with caution with the consideration of various covariate. The effect of pre-treatment of SDB on POAF should be examined in future. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to determine whether new-onset postoperative atrial fibrillation (NOPAF) among patients after hip arthroplasty can predict 1-year mortality. Methods: All patients over 65 years who underwent hip arthroplasty from January 2013 to December 2017 in a Chinese tertiary hospital were retrospectively analyzed. Patients with paroxysmal and persistent atrial fibrillation were ruled out. 2438 patients were identified to be eligible. The primary endpoint was 1-year mortality after the arthroplasty. Results: Among the 2438 patients, 101 (4.1%) had NOPAF and 2337 (95.9%) had not. Only the current use of beta blocker could predict the occurrence of NOPAF after hip arthroplasty. 1-year mortality for patients with NOPAF was significantly higher than that for patients without NOPAF (70.3% vs 19.0%; p < 0.001). Anti-arrhythmic and anticoagulant treatments were related to 1-year mortality, respectively. With multivariate analysis, NOPA was the most significant variable related to 1-year mortality (hazard ratio 7.8, 95% CI 2.9–24.6). Conclusions: Among elderly patients after hip arthroplasty, 1-year mortality is increased significantly for patients with NOPAF. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to identify whether the balance between T helper 17 (Th17) cells and CD4+CD25+Foxp3+ regulatory T (Treg) cells could predict the postoperative atrial fibrillation (POAF) after coronary artery bypass graft surgery (CABG).Methods: We enrolled 88 patients from Xinhua Hospital who received off-pump CABG (OPCABG) surgery. The baseline characteristics of patients were recorded. The preoperative variables C-reactive protein (CRP) level, left atrial (LA) volume, EuroSCORE I score, CHADS2 score, and CHA2DS2-VASc score were calculated at enrolment. Circulating Th17 and Treg cell frequencies were determined by flow cytometry, and expressions of Th17- and Treg-related cytokines were measured by enzyme-linked immunosorbent assay (ELISA).Results: Compared to patients without POAF, the CRP level and peripheral circulating Th17 cell were significantly increased in POAF patients. Th17/Treg ratio was positively correlated with CRP level, LA volume, CHADS2 score, and CHA2DS2-VASc score. The areas under the receiver-operating characteristic (AUC) curves of Th17/Treg ratio for predicting POAF occurrence was higher than that of CRP level, LA volume, CHADS2 score and CHA2DS2-VASc score. Th17/Treg ratio combined with CRP level has the highest AUC and a greater balance between sensitivity and specificity for predicting POAF.Conclusions: Our data suggest that a Th17/Treg imbalance due to a Th17 shift, representing a pro-inflammatory tendency, participates in the development of POAF. Combining the Th17/Treg ratio with CRP level may provide a more accurate, sensitive, and specific indicator for prediction of POAF. [ABSTRACT FROM AUTHOR]