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SYNTAX and Logistic Clinic SYNTAX Score as a Predictor of Atrial Fibrillation after Isolated Coronary Artery Bypass

Omer Tasbulak*,Begüm Uygur,Omer Celik,Mehmet Erturk,Ali Kemal Kalkan

Objective: Atrial fibrillation (AF) is the most common arrhythmia after coronary artery bypass grafting (CABG) surgery. In our study we aimed to evaluate if syntax score and logistic clinical syntax score (log CSS) predict AF after isolated CABG surgery.

Methods: This study was retrospectively designed and included total of 249 patients who underwent CABG at least 1 vessel lesssion between 2011-2013. The exclusion criteria were preoperative AF, emergent CABG operation, severe valvular diseases need operation, congenital heart diseases, severe organ failure and malignancy. The study population was divided into two groups (postoperative (Po) AF (+) group, PoAF(-) group) according to development of AF after CABG. Syntax score and log CSS were calculated in both groups. NCSS (Number Cruncher Statistical System) 2007 Statistical Software (Utah, USA) pocket programme was used.

Results: Retrospectively collected data showed in (PoAF) (+) group diabetes mellitus (DM) (p<0.001), uric acid (5.96 vs. 5.21 p=0.032), neutrophil count (6.11 vs. 5.08 p<0.01), neutrophil lymphocyte ratio (NLR) (3.48 vs. 2.54 p<0.01) were significantly higher than PoAF (-) group. In PoAF (+) group lymphocyte count (1.94 vs. 2.24 p<0.01) and ejection fraction (EF) (50.06 vs. 53.22 p=0.017) were significantly lower than postop AF (-) group. In Postop AF (+) group left anterior descending (LAD) artery-saphenous grafting (11.27% vs. 4.49% p<0.01) and circumflex (Cx) artery-saphenous grafting were significantly higher than PoAF (-) group (p=0.049). In PoAF (+) group, follow-up in intensive care unit (ICU) (days) (p=0.045) and follow-up in hospital (days) were significantly higher than PoAF (-) group (p=0.002). In PoAF (+) group, SYNTAX score (30.69 vs. 28.52 p<0.01) and log CSS were significantly higher than PoAF (-) group (8.34 vs. 6.49 p=0.001).

Conclusion: In our study, high HbA1c, NLR and SYNTAX score were found to be independent predictors of PoAF. But the power of SYNTAX score and log CSS to make a differential diagnosis of PoAF were not high.