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Background: The objectives of the CONSIDER AF (NCT02877745) observational study are to evaluate the impact of sleep-disordered breathing (SDB) on the rate of major adverse cardiac and cerebrovascular events in patients undergoing elective coronary artery bypass grafting (CABG) surgery. In addition, explorative analyses will allow specification of subgroups of patients with SDB with the highest risk for peri- and postoperative complications.Methods: CONSIDER AF is a single-center study in patients with and without SDB undergoing elective CABG. The presence and type of SDB are assessed the night prior to CABG using portable SDB monitoring. SDB is defined as an apnea-hypopnea index ≥15/h. Biomaterials (atrial myocardium and blood cells) are systematically sampled. New-onset atrial fibrillation and peri- and postoperative complications are prospectively evaluated during the hospital stay and over a period of 2 years. The relationship between postoperative complications and SDB or covariables associated with postoperative complications in univariable analyses are determined by multivariable logistic regression. Moreover, length of hospital stay and time spent in the intensive/intermediate care unit (ICU/IMC) of patients with and without SDB are analyzed. The harvested biomaterials are analyzed for novel signaling events and biomarkers.Discussion: The prospective observational CONSIDER AF study is needed to identify specific risks, including SDB, and risk populations in cardiac surgery. In addition, CONSIDER AF has the potential to generate the rationale for hypotheses regarding peri- and postoperative management of patients with SDB to be tested in future randomized clinical trials. Based on this knowledge, the peri- and postoperative management of patients with SDB may be optimized. [ABSTRACT FROM AUTHOR]

Background: Sleep-disordered breathing (SDB) may increase the risk of postoperative complications in patients after cardiac surgery. This study evaluated the length of hospital stay as well as postoperative cardiac, respiratory, and renal complications after elective coronary artery bypass grafting (CABG) in patients without SDB, with central sleep apnea (CSA), or with obstructive sleep apnea (OSA).Methods: The presence and type of SDB had been assessed with polygraphic recordings in 100 patients the night before elective CABG surgery. SDB was defined as an apnea-hypopnea index (AHI) of ≥ 15/h. Prolonged length of hospital stay (LOS) and postoperative hemodynamic instability due to any cause were retrospectively evaluated as primary endpoints and cardiac, respiratory, and renal complications as secondary endpoints.Results: 37% of patients had SDB, 14% CSA, and 23% OSA. LOS differed significantly between patients without SDB and those with CSA and OSA [median (25;75. percentile): 8.0 days (7.5;11.0) vs. 9.5 days (7.0;12.5) vs. 12.0 days (9.0;17.0), Kruskal-Wallis test between three groups: p = 0.023; OSA vs. no SDB: p = 0.005]. AHI was significantly associated with prolonged LOS [> 9 days; odds ratio (OR) (95% confidence interval): 1.047 (1.001;1.095), p = 0.044]. Prolonged need of vasopressors (≥ 48 h) was observed in 36% of patients without SDB, in 64% with CSA, and in 62% with OSA (p = 0.037). AHI was significantly associated with prolonged (≥ 48 h) need of vasopressors [OR (95% CI): 1.052 (1.002;1.104), p = 0.040], independent of any confounders.Conclusions: SDB, particularly OSA, is associated with prolonged LOS after CABG, independent of known confounders. Prolonged LOS in patients with SDB may be due to increased postoperative hemodynamic instability due to any cause. [ABSTRACT FROM AUTHOR]