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

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    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
    Issue Date
    2010-11
    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
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    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
    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
    ISSN
    1569-9285
    ae974a485f413a2113503eed53cd6c53
    10.1510/icvts.2010.242586
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