Background We aimed to investigate the risk factors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) in male and female patients without any history of AF, to identify the sex-specific risk factors, and to examine the effect of sex-specific risk factors on the overall population. Methods This retrospective study was conducted using the hospital database with 4,758 patients who underwent CABG surgery. Among them, 2,836 patients with complete data participated in this study. The female patients were divided into two groups as patients who developed new-onset AF after CABG and those who did not. The relationship between the patients' variables and risk factors of post-CABG AF was examined. Results The overall incidence of post CABG AF was 12.9% (386/2,836). Sex-specific incidence of AF was similar: 3.2% (91/690) and 12.9% (277/2146) in female and male patients, respectively (p = 0.849). Multiple analysis revealed the independent risk factors for male and female patients, respectively: mean age (odds ratio [OR] = 1.057, OR = 1,076), age over 65 years (OR = 2.156, OR = 2.736), the European System For Cardiac Operative Risk Evaluation Scores (EuroSCORE) (OR = 1.13, OR = 1.218), COPD (OR = 1.589, OR = 1.789), BUN level (OR = 1.026, OR = 1.019), mean cardiopulmonary bypass (CPB) time (OR = 1.007, OR = 1.010), prolonged CPB time (OR = 1.604, OR = 2.309), mean cross-clamp time (OR = 1.009, OR = 1.017), need of inotropic support (OR = 2.249, OR = 2.731), and mean mechanical ventilation time (VT) (OR = 1.026, OR = 1.027).Low left ventricular ejection fraction (LVEF) (OR = 1.419), left ventricular (LV) aneurysm repair (OR = 1.533), carotid artery disease (OR = 1.750), prolonged VT (OR = 1.729), and use of intra-aortic balloon pump (IABP) (OR = 2.436) were found to be the risk factors only for male AF patients.Unstable angina (OR = 1.969), right coronary artery (RCA) disease (OR = 2), prolonged cross-clamp time (OR = 2.152), and the number of grafts per operation (OR = 1.298) were found to be the risk factors only for female AF patients. Conclusion This study suggests that predictors of AF in the overall population may be due to isolated patient groups. Multiple regression analysis and artificial intelligence modelling should be performed on large-scale, isolated groups to make strong AF prediction.

Background: Doxorubicin (Dox)-induced cardiotoxicity is the most important side effect of the drug and significantly limits its use in susceptible patients. Therefore, preventive measures are required to alleviate the Dox-induced cardiac failure. In this study, curcumin, a strong antioxidant agent, was investigated for its potential protective effect on dox-induced cardiotoxicity with its effect on Apelin expression as a mediator of cardiac function. Methods: Wistar albino rats were equally divided into four groups as Control, DOX, CUR, and CUR+DOX. Dox was administered a single dose of 20 mg/kg bw intraperitoneally while 100 mg/kg bw curcumin was given orally for 14 days before the Dox use. Results: DOX group showed a prolonged QT interval on an electrocardiogram and elevated cardiac troponin levels. In biochemical analyses, decreased Superoxide Dismutase activity and increased Malondialdehyde level and Catalase activity were detected in DOX group. Gene expression of Apelin decreased significantly while NF-κB increased in DOX group. Degenerative changes in histopathology, and increased iNOS and nitrotyrosine immunoreactivity were detected in DOX group. However, no significant changes were observed at reduced Glutathione, TNF-, and IL-1β levels. Curcumin use in Dox-given rats altered most of the disturbed parameters investigated in this study, indicating an alleviating effect on Dox-induced cardiotoxicity. Serum and heart Apelin levels and mRNA expression in heart tissue were detected to significantly increase in CUR+DOX group as compared to DOX group. Furthermore, NF-κB mRNA expression was significantly decreased in heart tissue of CUR+DOX group compared with the DOX group. Conclusions: The results suggest that Apelin acts as an important mediator in Dox cardiotoxicity and may be used as a target for treatment of certain cardiomyopathies. By regulating Apelin expression, curcumin may serve as a potential adjunct in cardioprotective approaches.

Background Atrial fibrillation (AF), a condition that might occur after a heart bypass procedure, has caused differing estimates of its occurrence and risk. The current study analyses the possible risk factors of post-coronary artery bypass grafting (post-CABG) AF (postoperative AF [POAF]) and presents a software for preoperative POAF risk prediction. Methods This retrospective research was performed on 1,667 patients who underwent CABG surgery using the hospital database. The associations between the variables of the patients and AF risk factors after CABG were examined using multivariable logistic regression (LR) after preprocessing the relevant data. The tool was designed to predict POAF risk using Shiny, an R package, to develop a web-based software. Results The overall proportion of post-CABG AF was 12.2%. According to the results of univariate tests, in terms of age (p < 0.001), blood urea nitrogen (p = 0.005), platelet (p < 0.001), triglyceride (p = 0.0026), presence of chronic obstructive pulmonary disease (COPD; p = 0.01), and presence of preoperative carotid artery stenosis (PCAS; p < 0.001), there were statistically significant differences between the POAF and non-POAF groups. Multivariable LR analysis disclosed the independent risk factors associated with POAF: PCAS (odds ratio [OR] = 2.360; p = 0.028), COPD (OR = 2.243; p = 0.015), body mass index (OR = 1.090; p = 0.006), age (OR = 1.054, p < 0.001), and platelet (OR = 0.994, p < 0.001). Conclusion The experimental findings from the current research demonstrate that the suggested tool (POAFRiskScore v.1.0) can help clinicians predict POAF risk development in the preoperative period after validated on large sample(s) that can represent the related population(s). Simultaneously, since the updated versions of the proposed tool will be released periodically based on the increases in data dimensions with continuously added new samples and related factors, more robust predictions may be obtained in the subsequent stages of the current study in statistical and clinical terms.

Aim: This study aims to establish new-onset atrial fibrillation (AF) risk factors and postoperative outcomes after off-pump coronary artery bypass graft (CABG) surgery. Material and Methods: Four hundred ninety patients who underwent off-pump CABG were enclosed in study. Patients divided into two groups in line with the development of new-onset AF as AF group (n=62) and non-AF group (n=428). Groups were compared in terms of preoperative clinical features and perioperative data, and multivariate analysis accomplished to identify independent clinical predictors of AF following off-pump CABG. Results: AF was presented in 62 (12.7%) of the patients, and those were significantly older and had significantly higher additive EuroSCORE scores than without AF. Also patients with postoperative AF had significantly prolonged intensive care unit and longer hospital stays at postoperative period. In the multivariant logistic regression analysis performed, advanced age, mean Euroscore, Mild to moderate mitral regurgitation, Prolonged air leak from thorax drain, mean ventilation time, severe pleural effusion, need for inotropic drug support were found to be risk factors for postoperative AF. Conclusion: Our study showed that age, high Euroscore, mild to moderate mitral regurgitation, prolonged ventilation time, severe pleural effusion and low cardiac output were risk factors of postoperative AF in patients underwent off-pump CABG. Also In patients who developed postoperative AF, prolonged intensive care unit and hospital stays were observed. Prospective randomized studies with larger patient series are recommended to support our study.

This study aimed to clarify whether pulmonary hypertension is a risk factor for postoperative new-onset atrial fibrillation (NOAF) following isolated coronary artery bypass grafting (CABG). Data of 4,782 patients were retrospectively examined from clinical database, and data of isolated CABG performed patients (n = 854) with preoperative echocardiography including pulmonary artery pressure (PAP) measurement were enrolled in study. While 115 patients had post-CABG NOAF (atrial fibrillation [AF] group), 739 did not have AF (non-AF group). Demographic, clinical, and treatment-related parameters were compared between groups, and independent clinical predictors of NOAF were identified by multivariate analysis. Patients of AF group were significantly older and had higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) points, significantly elevated mean systolic PAP, and more pulmonary hypertension. Multivariate regression analysis revealed that mean systolic PAP (odds ratio [OR]: 1.027, 95% confidence interval [CI]: 1.006 - 1.048) and pulmonary hypertension (≥ 30 mmHg; OR: 1.659, 95% CI: 1.093 - 2.518) were independent risk factors for post-CABG NOAF. Chronic obstructive pulmonary disease (COPD) (OR: 2.033, 95% CI: 1.265 - 3.268) and mean duration of ventilation support (OR: 1.059, 95% CI: 1.017 - 1.104) were additionally determined as risk factors for post-CABG NOAF. This study identified patients' age, high EuroSCORE points, presence of COPD, prolonged ventilation support, and increased PAP as predictors of post-CABG NOAF. Understanding the risk factors will provide better guidance in preventing this complication and its potential consequences. Prospective randomized controlled trials are required to further validate these findings and provide more robust evidence.