Renal Failure, Gender, and the Development of Atrial Fibrillation (AF) following Coronary Artery Bypass Graft Surgery (CABG)

Background: Renal Failure is associated with accelerated atherosclerosis. It has been linked to higher inflammatory burden and to adverse cardiovascular events. Our aim was to find out the association between gender, renal function and the development of AF following CABG surgery.

Methods: A retrospective study that followed 239 patients that underwent CABG surgery in the Baruch Padeh Medical Center in the last 4 years. There were 34 women and 205 men, aged 61.85±9.57 years. Glomerular filtration rate (GFR), gender, and the development of atrial fibrillation were analyzed in a 2 way ANOVA.

Results: GFR levels were significantly better in male patients compared to female patients who developed atrial fibrillation (p=0.007), and the same favorable trend was noted in patients undergoing CABG who did not develop AF.

Discussion: Impaired renal function is more prevalent among women with coronary artery disease undergoing CABG who developed atrial fibrillation. Impaired renal failure leads to higher levels of free radicals and more significant inflammatory storms that are associated with a higher prevalence of post-operative complications like atrial fibrillation, heart failure, longer recovery periods, and a grave clinical outcome. Asymmetric Dimethyl Arginine (ADMA)’ is a competitive inhibitor of L-Arginine, which impairs nitric oxide (NO) production by the endothelial nitric oxide synthase in the endothelium, leading to the grave clinical outcome.