Abstract 11917: CHA2DS2-VASc Score and Risk of Subacute (<1 Month) Atrial Fibrillation After Cardiac Surgery

Introduction:Atrial fibrillation (AF) after cardiac surgery is a common acute phenomenon. Underlying mechanisms include both inflammation and pre-existing factors making the atria vulnerable to AF induction and maintenance. CHA2DS2-VASc score is a marker of atrial substrate. Subacute (<1 month) occurrence and relapse of AF after cardiac surgery are linked with AF in the long-term and adverse clinical outcomes.Hypothesis:The goal of our study was to assess whether baseline CHA2DS2-VASc score could contribute to an early estimation of subacute (<1 month) AF occurrence and relapse after cardiac surgery.Methods:We examined 338 cardiac surgical patients (221 male, 62?13 years, LVEF 57?10%, in sinus rhythm at baseline) who underwent coronary artery bypass graft and/or valve surgery followed by in-hospital rehabilitation. The median length of stay was 10 (8-14) days in the cardiac surgery department (acute phase) and 21 (16-27) days in the rehabilitation department (subacute phase). After cardiac surgery, AF occurrence during acute and subacute phases, AF recurrence in the subacute phase, acute and subacute CRP peak values were evaluated according to the baseline CHA2DS2-VASc score. Patients with CHA2DS2-VASc score 0 were compared to patients with CHA2DS2-VASc >3.Results:Overall, median CHA2DS2-VASc score was 2 (1-3). After cardiac surgery, acute AF, subacute AF and subacute AF relapse occurred in 129 (38,2%), 88 (26%) and 58 (17,2%) patients, respectively. Median acute and subacute CRP peaks were 186 (129-264) mg/L and 68 (39-120) mg/L, respectively. Between patients with CHA2DS2-VASc 0 and >3, any difference was observed in acute AF occurrence (p=0,757) and median CRP peak values (p=0,486). Conversely, subacute AF occurred more frequently in patients with CHA2DS2-VASc >3 (p=0,042) despite similar values of median CRP peak (p=0,894). Moreover, in patients with CHA2DS2-VASc >3 and AF history, subacute AF recurrence was higher than in the other group (p=0,016). The majority of CHA2DS2-VASC 0 patients (83%) did not show AF relapse in the subacute phase.Conclusions:Baseline CHA2DS2-VASc value > 3 allows to identify cardiac surgical patients at higher risk of subacute AF occurrence and relapse, independently of CRP values.