Abdominal aortic calcification as a potential predictor for postoperative atrial fibrillation in patients with aortic valve stenosis undergoing aortic valve replacement

Background: Postoperative atrial fibrillation (AF) is a common complication of cardiac surgery that has negative implications on patient outcomes. This study aimed to evaluate the effect of abdominal aortic calcification, measured using the Agatston Score, on patients undergoing aortic valve replacement for aortic valve stenosis. Methods and Results: This study included 183 patients who underwent aortic valve replacement. Preoperative characteristics and Agatston scores for abdominal aortic calcification were compared between patients with (n = 108) and without (n = 75) postoperative atrial fibrillation. Multivariate analysis showed that a high Agatston Score (derived by a cutoff point of 2767.65; odds ratio, 2.314; 95% confidence intervals (CI) , 1.063–5.041; P = 0.035), left atrial volumes (LAV) (derived by a cutoff point of 69.95; odds ratio, 3.176; 95% CI, 1.459–6.914; P = 0.004), and age (derived by a cutoff point of 75.5 years old, odds ratio, 3.465; 95% CI, 1.588–7.557; P = 0.003) were significant predictors of postoperative atrial fibrillation in the second week after surgery. Conclusions: Age and left atrial volume could be independent predictors of postoperative atrial fibrillation in patients with aortic valve stenosis, while the severity of abdominal aortic calcification, as measured using the Agatston Score, independently predicted postoperative atrial fibrillation during the second week following aortic valve stenosis. Patients with an Agatston Score exceeding 2767.65 should be considered at high risk and should receive appropriate management to improve outcomes.