Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors
Aim. To identify predictors of paroxysmal atrial fibrillation (pAF) in patients with stable angina after coronary artery bypass grafting (CABG), as well as to evaluate the effect of sodium-glucose cotransporter 2 (SGLT-2) inhibitors.Material and methods. We examined 92 patients with stable angina wh...
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Столичная издательская компания
2023-12-01
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| Series: | Рациональная фармакотерапия в кардиологии |
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| Online Access: | https://www.rpcardio.online/jour/article/view/2985 |
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| author | L. V. Kremneva L. A. Arutyunyan L. I. Gapon S. N. Suplotov S. V. Shalaev |
| author_facet | L. V. Kremneva L. A. Arutyunyan L. I. Gapon S. N. Suplotov S. V. Shalaev |
| author_sort | L. V. Kremneva |
| collection | DOAJ |
| description | Aim. To identify predictors of paroxysmal atrial fibrillation (pAF) in patients with stable angina after coronary artery bypass grafting (CABG), as well as to evaluate the effect of sodium-glucose cotransporter 2 (SGLT-2) inhibitors.Material and methods. We examined 92 patients with stable angina who received CABG, aged 64±7 years (men, 78,3%). Among this cohort, 81,5% of patients had multivessel coronary artery disease, carbohydrate metabolism disorders — 35,6%, hypertension — 96,7%, chronic kidney disease (CKD) — 23,9%, preprocedural pAF — 10,9%, previous myocardial infarction (MI) — 54,3%. Off-pump CABG was performed in 31,5%, including bilateral inthernal thoracic artery grafting — in 50%. Cardiopulmonary bypass time was 68 (55-83) minutes. The number of grafts was 2,7±0,7. In addition, 18,5% of individuals received SGLT-2 inhibitors. Serum creatinine content was determined by the Jaffe method, and CKD was diagnosed with glomerular filtration rate <60 ml/min. Acute kidney injury (AKI) was assessed according to the KDIGO criteria (2012).Results. The number of patients who had pAF after CABG was 29,3%, AKI — 16,3%. There were following parameters associated with pAF after CABG: creatinine (100;82-142 in patients with pAF and 83;69-105 μmol/l — without pAF, p=0,032) and urea (7,8;5,8-9,7 in patients with pAF and 5,9;4,7-9,1 mmol/l — without pAF, p=0,025) one day after the intervention; postoperative AKI was revealed in 33,3% and 9,2% (p=0,004), while the number of patients taking SGLT-2 inhibitors was 3,7% and 24,6% (p=0,019) in those with and without pAF, respectively. The probability of pAF after CABG increased by an average of 5,5 times with AKI. Patients with pAF after CABG compared to patients without pAF have a higher rate of AKI, intraoperative MI, and cardiac death.Conclusion. The number of patients with pAF after CABG was 29,3%, AKI — 16,3%. Post-CABG pAF predictor was postoperative AKI. The use of SGLT-2 inhibitors was associated with a lower incidence of pAF after intervention. Patients with pAF after CABG have a poor inhospital prognosis. |
| format | Article |
| id | doaj-art-b6588f835b754e9d95ce756e8a0db827 |
| institution | Kabale University |
| issn | 1819-6446 2225-3653 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj-art-b6588f835b754e9d95ce756e8a0db8272025-08-23T10:00:36ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532023-12-0119654955610.20996/1819-6446-2023-29852166Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitorsL. V. Kremneva0L. A. Arutyunyan1L. I. Gapon2S. N. Suplotov3S. V. Shalaev4Tyumen State Medical University; Tyumen Cardiology Research Center, Branch of the Tomsk National Research Medical CenterTyumen State Medical UniversityTyumen Cardiology Research Center, Branch of the Tomsk National Research Medical CenterTyumen State Medical UniversityTyumen State Medical UniversityAim. To identify predictors of paroxysmal atrial fibrillation (pAF) in patients with stable angina after coronary artery bypass grafting (CABG), as well as to evaluate the effect of sodium-glucose cotransporter 2 (SGLT-2) inhibitors.Material and methods. We examined 92 patients with stable angina who received CABG, aged 64±7 years (men, 78,3%). Among this cohort, 81,5% of patients had multivessel coronary artery disease, carbohydrate metabolism disorders — 35,6%, hypertension — 96,7%, chronic kidney disease (CKD) — 23,9%, preprocedural pAF — 10,9%, previous myocardial infarction (MI) — 54,3%. Off-pump CABG was performed in 31,5%, including bilateral inthernal thoracic artery grafting — in 50%. Cardiopulmonary bypass time was 68 (55-83) minutes. The number of grafts was 2,7±0,7. In addition, 18,5% of individuals received SGLT-2 inhibitors. Serum creatinine content was determined by the Jaffe method, and CKD was diagnosed with glomerular filtration rate <60 ml/min. Acute kidney injury (AKI) was assessed according to the KDIGO criteria (2012).Results. The number of patients who had pAF after CABG was 29,3%, AKI — 16,3%. There were following parameters associated with pAF after CABG: creatinine (100;82-142 in patients with pAF and 83;69-105 μmol/l — without pAF, p=0,032) and urea (7,8;5,8-9,7 in patients with pAF and 5,9;4,7-9,1 mmol/l — without pAF, p=0,025) one day after the intervention; postoperative AKI was revealed in 33,3% and 9,2% (p=0,004), while the number of patients taking SGLT-2 inhibitors was 3,7% and 24,6% (p=0,019) in those with and without pAF, respectively. The probability of pAF after CABG increased by an average of 5,5 times with AKI. Patients with pAF after CABG compared to patients without pAF have a higher rate of AKI, intraoperative MI, and cardiac death.Conclusion. The number of patients with pAF after CABG was 29,3%, AKI — 16,3%. Post-CABG pAF predictor was postoperative AKI. The use of SGLT-2 inhibitors was associated with a lower incidence of pAF after intervention. Patients with pAF after CABG have a poor inhospital prognosis.https://www.rpcardio.online/jour/article/view/2985coronary artery bypass graftingacute kidney injuryparoxysmal atrial fibrillationsodium-glucose cotransporter-2 inhibitorsinhospital complications |
| spellingShingle | L. V. Kremneva L. A. Arutyunyan L. I. Gapon S. N. Suplotov S. V. Shalaev Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors Рациональная фармакотерапия в кардиологии coronary artery bypass grafting acute kidney injury paroxysmal atrial fibrillation sodium-glucose cotransporter-2 inhibitors inhospital complications |
| title | Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors |
| title_full | Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors |
| title_fullStr | Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors |
| title_full_unstemmed | Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors |
| title_short | Acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting — effects of sodium-glucose cotransporter-2 inhibitors |
| title_sort | acute kidney injury as a risk factor for atrial fibrillation after coronary artery bypass grafting effects of sodium glucose cotransporter 2 inhibitors |
| topic | coronary artery bypass grafting acute kidney injury paroxysmal atrial fibrillation sodium-glucose cotransporter-2 inhibitors inhospital complications |
| url | https://www.rpcardio.online/jour/article/view/2985 |
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