Hypothyroidism is a Risk Factor for Atrial Fibrillation after Coronary Artery Bypass Graft

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 32; no. 6; pp. 475 - 480
• Main Authors: Jaimes, Marisol Carreno, Torrado, Luis Alberto Arciniegas, Reyes, Néstor Fernando Sandoval, Mackenzie, Jaime Camacho, Mallarino, Juan Pablo Umana
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01-01-2017
• Subjects: Aged; Atrial Fibrillation; Atrial Fibrillation - etiology; Atrial Fibrillation - mortality; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiac arrhythmia; Cardiology; Cardiovascular disease; Comorbidity; Coronary Artery Bypass; Coronary vessels; Data analysis; Diabetes; Female; Heart failure; Heart surgery; Hormones; Hospital Mortality; Humans; Hypothyroidism; Hypothyroidism - complications; Infections; Male; Metabolic disorders; Middle Aged; Mortality; Myocardial Revascularization - adverse effects; Normal distribution; Original; Patients; Postoperative Complications - etiology; Postoperative Complications - mortality; Retrospective Studies; Risk Factors; Sample size; SURGERY; Systematic review; Thyroid gland; Variables; Coronary Artery Bypass; Hormones; Hypothyroidism; Atrial Fibrillation
• ISSN: 0102-7638; 1678-9741; 1678-9741
• DOI: 10.21470/1678-9741-2017-0080

Few reports in the world have shown a differential effect of hypothyroidism in relation to morbidity and mortality following cardiac surgery.
To determine the association between preoperative hypothyroidism, composite and disaggregated outcomes of mortality and complications in patients undergoing first-time isolated myocardial revascularization surgery.
Historical cohort of patients undergoing myocardial revascularization between January 2008 and December 2014, with 626 patients included for evaluation of the composite and disaggregated outcomes of in-hospital mortality and complications (atrial fibrillation, surgical site infection and reoperation due to bleeding). A logistic regression model was used to determine the association between hypothyroidism and the onset of those outcomes.
Cohort of 1696 eligible patients for the study, with 1.8 mortality. Median age, female gender and prevalence of arterial hypertension were all significantly higher among hypothyroid patients. No differences were found in other preoperative or intraoperative characteristics. Hypothyroidism was associated with the presence of the composite outcome, RR 1.6 (1.04-2.4) and atrial fibrillation 1.9 (1.05-3.8). No association with mortality, infections or reoperation due to bleeding was found.
Hypothyroidism is a disease that affects females predominantly and does not determine the presence of other comorbidities. Hypothyroidism is a risk factor for the onset of postoperative fibrillation in patients undergoing myocardial revascularization surgery. Postoperative care protocols focused on the prevention of these complications in this type of patients must be instituted.