冠状动脉旁路移植术术后新发心房颤动的危险因素及预防研究进展

骆迪; 罗菲; 王莹; 张薇; 李晖

doi:10.3969/j.issn.1004-3594.2026.06.016

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武警医学 ›› 2026, Vol. 37 ›› Issue (6) : 548-552. DOI: 10.3969/j.issn.1004-3594.2026.06.016

综述　

冠状动脉旁路移植术术后新发心房颤动的危险因素及预防研究进展

骆迪¹, 罗菲¹, 王莹¹, 张薇¹, 李晖²

作者信息 +

文章历史 +

摘要

冠状动脉旁路移植术(CABG)术后最常见的并发症为心房颤动,其发生率为13%～40%,不仅影响患者的病情转归,延长住院时间,还增加了死亡的风险。本文对CABG术后新发心房颤动的研究进展作一综述,以期早期识别并采取相应的措施预防和治疗,为降低术后心房颤动的发生率提供参考。

关键词

冠状动脉旁路移植术 / 心房颤动 / 危险因素 / 预防 / 研究进展

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骆迪, 罗菲, 王莹, 张薇, 李晖. 冠状动脉旁路移植术术后新发心房颤动的危险因素及预防研究进展[J]. 武警医学. 2026, 37(6): 548-552 https://doi.org/10.3969/j.issn.1004-3594.2026.06.016

中图分类号： R541.75 R654.2

参考文献

[1] Andreae C,Tingström P,Nilsson S,et al.Does problem-based learning improve patient empowerment and cardiac risk factors in patients with coronary heart disease in a Swedish primary care setting? A long-term prospective, randomised, parallel single randomised trial (COR-PRIM)[J].BMJ Open,2023,13(2):e065230.
[2] Blakoe M,Christensen A V,Palm P,et al.Prognostic value of a brief loneliness questionnaire for patients with coronary heart disease:proposal for a prediction model[J].J Clin Nurs,2022,31(11-12):1686-1696.
[3] Wickbom A,Fengsrud E,Alfredsson J,et al.Atrial fibrillation incidence after coronary artery bypass graft surgery and percutaneous coronary intervention:the prospective AFAF cohort study[J].Scand Cardiovasc J,2024, 58(1):2347297.
[4] Ogawa S,Mori Y,Batkhishig T,et al.Propensity score analysis comparing off-pump versus on-pump coronary artery bypass grafting in older adults[J].Gen Thorac Cardiovasc Surg,2023,71(9):498-504.
[5] Lee H,Kim H J,Yoo J S,et al.Early pharmacologic conversion of atrial fibrillation after off-pump coronary artery bypass grafting[J].J Thorac Dis,2021,13(7):4072-4082.
[6] Malhotra P,Pande S,Mahindru S,et al.Postoperative atrial fibrillation in coronary artery bypass grafting herald poor outcome[J].Ann Card Anaesth,2021,24(4):464-469.
[7] Maia A D S,Mayer D H,Silva R A G E,et al.Atrial fibrillation after coronary artery bypass grafting and its relationship with hospital complications in são paulo state[J].Braz J Cardiovasc Surg,2024,39(4):e20230270.
[8] Son Y J,Choi H J,Shim J.Association between postoperative atrial fibrillation after coronary artery bypass grafting and short-term clinical outcomes[J].BMC Cardiovasc Disord,2024,24(1):578.
[9] Higgs M,Sim J,Traynor V.Incidence and risk factors for new-onset atrial fibrillation following coronary artery bypass grafting:a systematic review and meta-analysis[J].Intensive Crit Care Nurs,2020,60:102897.
[10] Zhou J Y,Zhang J L,Xi L,et al.Risk factors of postoperative atrial fibrillation after isolated coronary artery bypass grafting surgery in the recent 10 years:clinical analysis of 6229 patients[J].Clin Cardiol,2024,47(10):e24335.
[11] Seo E J,Hong J,Lee H J,et al.Perioperative risk factors for new-onset postoperative atrial fibrillation after coronary artery bypass grafting:a systematic review[J].BMC Cardiovasc Disord,2021,21(1):418.
[12] Rum M,Er H,Yilmaz F,et al.Postoperative atrial fibrillation following isolated coronary artery bypass grafting:incidence, predictors, and clinical outcomes[J].J Coll Physicians Surg Pak,2025,35(9):1083-1087.
[13] 宋媛媛,张伟.糖尿病及红细胞分布宽度变异系数对非体外循环冠状动脉旁路移植术后心房颤动的影响[J].临床心血管病杂志,2025,41(9):728-732.
[14] 钱路路,管玉珍,戴莉.OPCABG术后新发AF的危险因素及列线图预测模型构建[J].心血管康复医学杂志,2025,34(4):465-469.
[15] 王芳,张武学,朱国栋,等.老年冠心病患者行冠状动脉旁路移植术后新发心房颤动的危险因素分析[J]. 中国医学创新,2025,22(13):154-158.
[16] Filardo G,Ailawadi G,Pollock B D,et al.Postoperative atrial fibrillation:sex-specific characteristics and effect on survival[J].J Thorac Cardiovasc Surg,2020,159(4):1419-1425.
[17] Hameed I,Malik S,Nusrat K,et al.Effect of vitamin D on postoperative atrial fibrillation in patients who underwent coronary artery bypass grafting:a systematic review and meta-analysis[J].J Cardiol,2023,82(3):220-224.
[18] Perrier S,Meyer N,Hoang Minh T,et al.Predictors of atrial fibrillation after coronary artery bypass grafting:a Bayesian analysis[J].Ann Thorac Surg,2017,103(1):92-97.
[19] Smukowska-Gorynia A,Perek B,Jemielity M,et al.Neopterin as a predictive biomarker of postoperative atrial fibrillation following coronary artery bypass grafting[J].Kardiol Pol,2022,80(9):902-910.
[20] Eini P,Serpoush H,Rezayee M,et al.Machine learning and regression-based models for prediction of postoperative atrial fibrillation following coronary artery bypass grafting:a systematic review and meta-analysis[J].Int J Cardiol Cardiovasc Risk Prev,2026,29:200619.
[21] Bradley D,Creswell L L,Hogue C W,et al.Pharmacologic prophylaxis:American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery[J].Chest, 2005,128(Suppl 2):39S-47S
[22] Wei Y,Zhang Q,Chi H,et al.Effects of recombinant human brain natriuretic peptide on atrial fibrillation after coronary artery bypass grafting[J].J Cardiovasc Pharmacol,2023,81(1):63-69.
[23] Okiljevic B,Zdravkovic R,Preveden A,et al.The effect of silymarin on the prevention of atrial fibrillation after coronary artery bypass grafting[J].Braz J Cardiovasc Surg,2024,e20230422.
[24] San T M M,Han K P P,Ismail M,et al.Pericardiotomy and atrial fibrillation after isolated coronary artery bypass grafting:a systematic review and meta-analysis of 16 randomised controlled trials[J].Cardiovasc Revasc Med,2024,66:27-32.
[25] Ruan Y,Robinson N B,Naik A,et al.Effect of atrial pacing on post-operative atrial fibrillation following coronary artery bypass grafting:pairwise and network meta-analyses[J].Int J Cardiol,2020,302:103-107.
[26] Yang Z,Tiemuerniyazi X,Xu F,et al.Partial cardiac denervation to prevent postoperative atrial fibrillation after coronary artery bypass grafting:the pCAD-POAF randomized clinical trial[J].JAMA Cardiol,2025,10(1):71-77.
[27] Ali J,Khan M H,Majeed Z,et al.Prophylactic cardiac denervation to prevent post-operative atrial fibrillation after coronary artery bypass grafting:a systematic review and meta-analysis[J].J Interv Card Electrophysiol, 2025,68(8):1671-1682.
[28] El-Essawi A,Abdelhalim A,Groeger S,et al.Predictors of postoperative atrial fibrillation persisting beyond hospital discharge after coronary artery bypass grafting[J].Perfusion,2022,37(1):62-68.
[29] Khan M S,Yamashita K,Sharma V,et al.Perioperative biomarkers predicting postoperative atrial fibrillation risk after coronary artery bypass grafting:a narrative review[J].J Cardiothorac Vasc Anesth,2020,34(7):1933-1941.
[30] Topal D,Korkmaz U T K,Velioglu Y,et al.Systemic immune-inflammation index as a novel predictor of atrial fibrillation after off-pump coronary artery bypass grafting[J].Rev Assoc Med Bras,2022,68(9):1240-1246.
[31] Yilmaz Y,Kelesoglu S,Elcik D,et al.Predictive values of systemic immune-inflammation index in new-onset atrial fibrillation following coronary artery bypass grafting[J].Braz J Cardiovasc Surg,2023,38(1):96-103.
[32] 王永坤,张利,金辉,等.泛免疫炎症值与冠状动脉旁路移植术后心房颤动的相关性研究[J].中国循证心血管医学杂志,2025,17(7):812-815.
[33] Badem S,Pekcolaklar A.Inflammatory prognostic index predicts new-onset atrial fibrillation and mortality after on-pump coronary artery bypass grafting[J].Rev Assoc Med Bras,2023,69(8):e20230226.
[34] Yerukala Sathipati S,Carter T,Soodi D,et al.MicroRNA signature predicts post operative atrial fibrillation after coronary artery bypass grafting[J].Sci Rep,2025,15(1):18658.
[35] Cui X,Xu C,Chen C,et al.New-onset post-operative atrial fibrillation in patients undergoing coronary artery bypass grafting surgery-a retrospective case-control study[J].Braz J Cardiovasc Surg,2023,38(1):149-156.
[36] Hu Y,Mei J,Chen S,et al.Nonlinear association and threshold effect between preoperative estimated pulse wave velocity and postoperative atrial fibrillation after coronary artery bypass grafting[J].J Thorac Dis,2026, 18(2):147-159.