Variation in the 4q25 chromosomal locus predicts atrial fibrillation after coronary artery bypass graft surgery. Circ Cardiovasc Genet 2009; 2:499 -506 Atrial fibrillation (AF) occurs in 27-40% of cases after cardiac surgery. AF is associated with increased risk of complications and increased healthcare resource utilization. In ambulatory patients, four single-nucleotide polymorphisms (SNPs) within the 4q25 chromosomal regional were identified, and clinical and genetic predictors of AF have

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... validated. Their role in postoperative AF is unknown. This multicenter prospective study assessed whether the genetic variants in the 4q25 chromosomal region are independently associated with postoperative AF after coronary artery bypass graft (CABG) surgery using two prospectively collected cohorts of patients undergoing CABG with cardiopulmonary bypass and with or without concurrent valve surgery. Clinical and genomic multivariate predictors of postoperative AF were identified by genotyping 45 SNPs encompassing the 4q25 locus in the discovery cohort (n ϭ 959 patients; 30.1% had postoperative AF). Validation of three SNPs were then assessed in a separately collected cohort (n ϭ 494 patients, 30.6% had postoperative AF). Older patients and patients with prior AF were at higher risk for postoperative AF, whereas postoperative "statin" use reduced the risk. After adjustment for clinical predictors of postoperative AF, and multiple comparisons, seven SNPs independently predicted postoperative AF in the discovery cohort. Additive odds ratios for the seven associated 4q25 SNPs ranged between 1.57 and 2.17 (P ϭ 0.0008.0 -0.000034). The rs10033464 SNP associated with AF in ambulatory patients was not observed for postoperative AF. Association with postoperative AF were measured and replicated for rs2200733 and rs13143308 in the validation cohort. Interpretation Atrial fibrillation remains a significant complication after coronary artery bypass surgery. Patients who have single nucleotide polymorphisms at the chromosome 4q25 region have increased risk for developing atrial fibrillation after bypass surgery. Further research is needed to determine whether preoperative testing for this genetic alteration can lead to early treatment and prevention of atrial fibrillation. Delirium after coronary artery bypass graft surgery and late mortality. Ann Neurol 2010; 67:338 -44