Abstract
BACKGROUND: The visceral-adiposity-tissue index (VATI) and the triglyceride-glucose (TyG) index were found to be correlated with an increased risk of cardiovascular events. However, data concerning the association between the visceral adiposity/TyG indexes and the complication of new-onset postoperative atrial fibrillation (POAF), especially in patients who had just undergone off-pump coronary artery bypass grafting (OPCABG), are rare. We explored the predictive value of the computed-tomography-based VATI and the TyG index on new-onset POAF after OPCABG. METHODS: This study used longitudinal data from the cohort of 542 participants who underwent OPCABG in Beijing Anzhen Hospital since June 2017. The predictive relevance of the VATI and TyG index were evaluated through Cox proportional hazards models and receiver operating characteristic (ROC) curves. The dose‒response relationship of the VATI and TyG index with new-onset POAF was analyzed by multiple-adjusted spline regression models, and sensitivity analysis was used to explore the stability of our findings. RESULTS: The analysis found that the highest tertile of VATI [hazard ratio (HR) 2.58, 95% confidence interval (CI) 1.12-3.45; p = 0.01] and TyG index (HR 2.88, 95% CI 1.76-4.71; p = 0.01) were significantly associated with new-onset POAF compared to the lowest tertile after full adjustment for age, sex, body mass index, c-reactive protein levels, diabetes, emergency operation, New York Heart Association (NYHA) III-IV, and left atrial diameter. The area under the ROC curve (AUC) was 0.897 (p < 0.001) and 0.878 (p < 0.001) for the VATI and TyG index, respectively. In addition, the multiple-adjusted spline regression models showed a nonlinear relationship between new-onset POAF and VATI and TyG index (p for nonlinearity < 0.001). Sensitivity analyses confirmed that the results were similar for most tertiles. CONCLUSIONS: The VATI and TyG index were significantly associated with an increased risk for the development of new-onset POAF after OPCABG. CLINICAL TRIAL REGISTRATION: NCT03729531, https://beta.clinicaltrials.gov/study/NCT03729531.