Revista do Colégio Brasileiro de Cirurgiões
https://revistadocbc.org.br/article/doi/10.1590/0100-6991e-202600176
Revista do Colégio Brasileiro de Cirurgiões
Original Article

Doença arterial periférica como fator de risco para fibrilação atrial no período pós-operatório de cirurgia de revascularização do miocárdio: um estudo de coorte retrospectivo

Peripheral arterial disease as a risk factor for atrial fibrillation in the postoperative period of myocardial revascularization: a retrospective cohort study

Fernando Graça Aranha; Adriana Ferraz Martins; Marcos Arêas Marques; Marcelo Ferraz Martins Graça Aranha; Felipe Ferraz Martins Graça Aranha; Isabel de Castro Nunes Senftt; Marina Araujo Zulchner; Jefferson Traebert

http://dx.doi.org/10.1590/0100-6991e-202600176 RCBC, vol.53, e2026001726, 2026
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Resumo

Introdução: A fibrilação atrial pós-operatória (FAPO) é a complicação mais comum da cirurgia de revascularização miocárdica, sendo associada a fatores predisponentes e a desfechos como aumento do tempo de internação hospitalar, maiores taxas de acidente vascular encefálico e mortalidade. O objetivo deste estudo é estimar a incidência de FAPO e os fatores e desfechos associados, com ênfase na doença arterial periférica.

Métodos: Foi realizado um estudo de coorte retrospectivo, envolvendo pacientes adultos admitidos na unidade de terapia intensiva no período pós-operatório imediato de cirurgia de revascularização miocárdica em um hospital privado da região sul do Brasil. Foram coletados dados sociodemográficos, comorbidades, tempo de internação hospitalar e em unidade de terapia intensiva, ocorrência de acidente vascular encefálico e óbito. Análises multivariadas foram realizadas para identificar relações independentes entre as variáveis, utilizando regressão de Poisson com estimador robusto. Os riscos relativos e os intervalos de confiança de 95% foram estimados.

Resultados: 421 pacientes foram incluídos. A incidência de FAPO foi de 23,8% (100 pacientes), associada de forma estatisticamente significativa e independente à maior idade do paciente (p<0,001), à hipertensão arterial sistêmica (p<0,001) e à doença arterial periférica (p<0,001). O aumento da incidência de FAPO também foi associado ao maior tempo de internação hospitalar e em unidade de terapia intensiva.

Conclusão: A maior incidência de FAPO após revascularização miocárdica foi associada à doença arterial periférica, maior idade e hipertensão arterial sistêmica.

Palavras-chave

Fibrilação Atrial; Arritmias Cardíacas; Revascularização Miocárdica; Cuidados Perioperatórios

Abstract

Introduction: Postoperative atrial fibrillation (POAF) is the most common complication of myocardial revascularization surgery, associated with predisposing factors and outcomes such as increased hospital stay, higher stroke and mortality rates. The objective of this study is to estimate the incidence of POAF and associated factors and outcomes, with emphasis on peripheral arterial disease.

Methods: A retrospective cohort study was carried out involving adult patients admitted to admitted to the intensive care unit in the immediate postoperative period of myocardial revascularization surgery in a private hospital in South Brazil. Sociodemographic data, comorbidities, hospital and intensive care unit stay, occurrence of stroke and death were collected. Multivariate analyses were performed to identify independent relationships between variables using Poisson Regression with a robust estimator. Relative risks and 95% confidence intervals were estimated.

Results: A total of 421 patients were included. The incidence of POAF was 23.8% (100 patients), statistically and independently associated with patient’s older age (p<0.001), with systemic arterial hypertension (p<0.001) and with peripheral arterial disease (p<0.001). Increased incidence of POAF was also associated with increased hospital and intensive care unit length of stay.

Conclusion: A higher incidence of POAF after myocardial revascularization was associated with peripheral arterial disease, older age, and systemic arterial hypertension.

Keywords

Atrial Fibrillation; Arrhythmias, Cardiac; Myocardial Revascularization; Perioperative Care

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Submitted date:
02/12/2026

Accepted date:
04/07/2026

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