Association between obesity and postoperative atrial fibrillation in patients undergoing cardiac operations: a systematic review and meta-analysis

Abstract

In a systematic review and random-effects meta-analysis, we evaluated whether obesity is associated with postoperative atrial fibrillation (POAF) in patients undergoing cardiac operations. We selected 18 observational studies until December 2011 that excluded patients with preoperative AF (n=36,147). Obese patients had a modest higher risk of POAF compared with nonobese (odds ratio, 1.12; 95% confidence interval, 1.04 to 1.21; p=0.002). The association between obesity and POAF did not vary substantially by type of cardiac operation, study design, or year of publication. POAF was significantly associated with a higher risk of stroke, respiratory failure, and operative death.

Keywords: 24; ACE; AF; ARBs; BMI; BSA; CABG; CAD; CHF; CI; CK-MB; COPD; CPBT; CVD; DM; ECC; EDIVST; EF; ESIVST; FE; FFP; HDL; IABP; ICU; IV; LDL; LVEF; M-H; MI; MOOSE; Mantel-Haenszel; Meta-analysis of Observational Studies in Epidemiology; NA; OR; PC; POAF; PRISMA; PUFA; PVD; Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RBC; RC; RF; SD; SE; SPB; angiotensin II receptor blockers; angiotensin-converting enzyme; atrial fibrillation; body mass index; body surface area; cardiopulmonary bypass time; cerebrovascular disease; chronic obstructive pulmonary disease; confidence interval; congestive heart failure; coronary artery bypass grafting; coronary artery disease; creatinine kinase-myocardial band; diabetes mellitus; ejection fraction; end-diastolic intraventricular septum thickness; end-systolic intraventricular septum thickness; extracorporeal circulation; finite element; fresh frozen plasma; high density lipoprotein; intensive care unit; intraaortic balloon pump; inverse variance; left ventricular ejection fraction; low density lipoprotein; myocardial infarction; not available; odds ratio; peripheral vascular disease; polyunsaturated fatty acid; postoperative atrial fibrillation; prospective cohort; red blood cells; respiratory failure; retrospective cohort; standard deviation; standard error; supraventricular premature beats.