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dc.contributor.authorAl-Sarraf, Nael
dc.contributor.authorThalib, Lukman
dc.contributor.authorHughes, Anne
dc.contributor.authorHoulihan, Maighread
dc.contributor.authorTolan, Michael
dc.contributor.authorYoung, Vincent
dc.contributor.authorMcGovern, Eillish
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
refterms.dateFOA2018-08-22T11:43:41Z
html.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.


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