The risk of arrhythmias following coronary artery bypass surgery: do smokers have a paradox effect?

Hdl Handle:
http://hdl.handle.net/10147/125890
Title:
The risk of arrhythmias following coronary artery bypass surgery: do smokers have a paradox effect?
Authors:
Al-Sarraf, Nael; Thalib, Lukman; Hughes, Anne; Houlihan, Maighread; Tolan, Michael; Young, Vincent; McGovern, Eillish
Affiliation:
Department of Cardiothoracic Surgery, St. James's Hospital, Dublin 8, Ireland. trinityq8@hotmail.com
Citation:
The risk of arrhythmias following coronary artery bypass surgery: do smokers have a paradox effect? 2010, 11 (5):550-5 Interact Cardiovasc Thorac Surg
Journal:
Interactive cardiovascular and thoracic surgery
Issue Date:
Nov-2010
URI:
http://hdl.handle.net/10147/125890
DOI:
10.1510/icvts.2010.242586
PubMed ID:
20713536
Abstract:
Smoking is reported to increase the risk of arrhythmias. However, there are limited data on its effects on arrhythmias following coronary artery bypass graft (CABG). This is a retrospective review of a prospective database of all CABG patients over an eight-year period. Our cohort (n=2813) was subdivided into: current (n=1169), former (n=837), and non-smokers (n=807). Predictors of arrhythmias following CABG in relation to smoking status were analysed. Atrial arrhythmias occurred in 942 patients (33%). Ventricular arrhythmias occurred in 48 patients (2%) and high-grade atrioventricular block occurred in five patients (0.2%). Arrhythmias were lower in current smokers than former and non-smokers (29% vs. 40% vs. 39%, respectively P<0.001). Logistic regression analysis showed 30% arrhythmia risk reduction in smokers compared to non-smokers [odds ratio (OR) 0.7, 95% confidence intervals (CI) 0.5-0.8] and this effect persisted after accounting for potential confounders while former smokers had the same risk as non-smokers (OR 1.04, CI 0.9-1.3). There were no significant differences in mortality. Smokers are less prone to develop arrhythmias following CABG. This paradox effect is lost in former smokers. This effect is possibly due to a lower state of hyper adrenergic stimulation observed in smokers than non-smokers following the stress of surgery.
Item Type:
Article
Language:
en
MeSH:
Adult; Aged; Aged, 80 and over; Arrhythmias, Cardiac; Chi-Square Distribution; Coronary Artery Bypass; Databases as Topic; Female; Humans; Ireland; Logistic Models; Male; Middle Aged; Odds Ratio; Retrospective Studies; Risk Assessment; Risk Factors; Smoking; Time Factors; Treatment Outcome
ISSN:
1569-9285

Full metadata record

DC FieldValue Language
dc.contributor.authorAl-Sarraf, Naelen
dc.contributor.authorThalib, Lukmanen
dc.contributor.authorHughes, Anneen
dc.contributor.authorHoulihan, Maighreaden
dc.contributor.authorTolan, Michaelen
dc.contributor.authorYoung, Vincenten
dc.contributor.authorMcGovern, Eillishen
dc.date.accessioned2011-03-28T14:49:55Z-
dc.date.available2011-03-28T14:49:55Z-
dc.date.issued2010-11-
dc.identifier.citationThe risk of arrhythmias following coronary artery bypass surgery: do smokers have a paradox effect? 2010, 11 (5):550-5 Interact Cardiovasc Thorac Surgen
dc.identifier.issn1569-9285-
dc.identifier.pmid20713536-
dc.identifier.doi10.1510/icvts.2010.242586-
dc.identifier.urihttp://hdl.handle.net/10147/125890-
dc.description.abstractSmoking is reported to increase the risk of arrhythmias. However, there are limited data on its effects on arrhythmias following coronary artery bypass graft (CABG). This is a retrospective review of a prospective database of all CABG patients over an eight-year period. Our cohort (n=2813) was subdivided into: current (n=1169), former (n=837), and non-smokers (n=807). Predictors of arrhythmias following CABG in relation to smoking status were analysed. Atrial arrhythmias occurred in 942 patients (33%). Ventricular arrhythmias occurred in 48 patients (2%) and high-grade atrioventricular block occurred in five patients (0.2%). Arrhythmias were lower in current smokers than former and non-smokers (29% vs. 40% vs. 39%, respectively P<0.001). Logistic regression analysis showed 30% arrhythmia risk reduction in smokers compared to non-smokers [odds ratio (OR) 0.7, 95% confidence intervals (CI) 0.5-0.8] and this effect persisted after accounting for potential confounders while former smokers had the same risk as non-smokers (OR 1.04, CI 0.9-1.3). There were no significant differences in mortality. Smokers are less prone to develop arrhythmias following CABG. This paradox effect is lost in former smokers. This effect is possibly due to a lower state of hyper adrenergic stimulation observed in smokers than non-smokers following the stress of surgery.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshArrhythmias, Cardiac-
dc.subject.meshChi-Square Distribution-
dc.subject.meshCoronary Artery Bypass-
dc.subject.meshDatabases as Topic-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshLogistic Models-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshOdds Ratio-
dc.subject.meshRetrospective Studies-
dc.subject.meshRisk Assessment-
dc.subject.meshRisk Factors-
dc.subject.meshSmoking-
dc.subject.meshTime Factors-
dc.subject.meshTreatment Outcome-
dc.titleThe risk of arrhythmias following coronary artery bypass surgery: do smokers have a paradox effect?en
dc.typeArticleen
dc.contributor.departmentDepartment of Cardiothoracic Surgery, St. James's Hospital, Dublin 8, Ireland. trinityq8@hotmail.comen
dc.identifier.journalInteractive cardiovascular and thoracic surgeryen

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