학술논문
Subclinical Hypothyroidism Might Increase the Risk of Postoperative Atrial Fibrillation after Aortic Valve Replacement.
Document Type
Academic Journal
Author
Martínez-Comendador J; Department of Cardiac Surgery, Hospital of Leon, Leon, Spain.; Marcos-Vidal JM; Department of Anesthesiology, Hospital of Leon, Leon, Spain.; Gualis J; Department of Cardiac Surgery, Hospital of Leon, Leon, Spain.; Martin CE; Department of Cardiac Surgery, Hospital of Leon, Leon, Spain.; Martin E; Department of Cardiac Surgery, Hospital of Leon, Leon, Spain.; Otero J; Department of Cardiac Surgery, Hospital of Leon, Leon, Spain.; Castaño M; Department of Cardiac Surgery, Hospital of Leon, Leon, Spain.
Source
Publisher: Thieme Country of Publication: Germany NLM ID: 7903387 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1439-1902 (Electronic) Linking ISSN: 01716425 NLM ISO Abbreviation: Thorac Cardiovasc Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Background To evaluate the influence of subclinical hypothyroidism (SCH) on the development of postoperative atrial fibrillation (AF) in patients undergoing aortic valve replacement surgery with extracorporeal circulation. Methods A prospective study in a tertiary hospital between July 2005 and December 2013 in which all patients undergoing aortic valve replacement with no other valve surgery were consecutively included. Patients who were in preoperative sinus rhythm were selected and they underwent thyroxine (T4) and thyroid-stimulating hormone determination in the month before surgery. Postoperative AF was defined as the development of AF during hospital admittance. Descriptive analysis and binary logistic regression were performed for the target variable. Results A total of 467 patients were studied, with 35 cases of SCH. The incidence of postoperative AF was 57% in the group with SCH versus 30.3% (p = 0.001) in the group without hypothyroidism, without significant differences in other postoperative complications. In the logistic regression analysis, the independent predictors of postoperative AF were SCH, age, and aortic clamping time. SCH multiplies the odds ratio of postoperative AF by 3.14 (95% confidence interval: 1.24-7.96). Conclusion SCH behaves like a risk factor for the development of postoperative AF in patients undergoing aortic valve replacement with extracorporeal circulation. Other studies are needed to determine whether preoperative T4 replacement therapy and/or more aggressive AF prophylaxis can prevent this complication in patients undergoing aortic valve replacement.
(Georg Thieme Verlag KG Stuttgart · New York.)
(Georg Thieme Verlag KG Stuttgart · New York.)