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Atrial fibrillation in elderly patients after coronary artery bypass grafting; gender differences in outcome.
Scand Cardiovasc J. 2005 Oct; 39(5):293-8.SC

Abstract

OBJECTIVES

To evaluate gender-related differences in preoperative risk factors, hospital events, especially atrial fibrillation (AF), and length of stay in elderly patients undergoing isolated coronary artery bypass grafting (CABG).

DESIGN

Prospectively collected data from consecutive patients undergoing isolated CABG in Tampere University Hospital between May 1999 and November 2000, in total 1131 patients.

RESULT

We analysed 621 patients 65 years and older of whom 401 (65%) were male. When evaluating gender differences we found that the women were older (73 vs. 71 yrs, p<0.001) and significantly more often had hypertension (66% vs. 49%, p<0.001) and chronic heart insufficiency (11% vs. 4%, p=0.001). The NYHA classification of the women was worse (3.4 vs. 3.1, p<0.001) and in the angiographic data they had left main stenosis more often (31% vs. 21%, p=0.005) than the men. The women needed longer hospitalisation (19 vs. 15 days, p<0.001). There was no difference in the prevalence of postoperative AF between the genders, but in spite of that women had more postoperative strokes (6% vs. 3%, p=0.028) and also other major complications (29% vs. 19%, p=0.004) than the men. The 30-day mortality was higher in the female group (8% vs. 5%, p=0.06). We analysed preoperative risk factors and found that the females had a 1.6-fold risk for postoperative major complication after adjustment for age and other risk factors. In a logistic regression analysis age and the number of anastomoses emerged as independent predictors of AF in males, but in females we could not find any predictor for postoperative AF.

CONCLUSIONS

The women are older and have more comorbidities and risk factors at the time of CABG. They also have more postoperative complications, but not a significantly higher mortality. Importantly, the excess of morbidity remains after adjustment for age and underlying risk factors. There is no gender difference in the incidence of postoperative AF in the elderly population. However, it seems to occur independent of age in the women only.

Authors+Show Affiliations

Department of Internal Medicine, Paijat-Hame Central Hospital, Lahti, Finland. liisa.kokkonen@fimnet.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16269399

Citation

Kokkonen, L, et al. "Atrial Fibrillation in Elderly Patients After Coronary Artery Bypass Grafting; Gender Differences in Outcome." Scandinavian Cardiovascular Journal : SCJ, vol. 39, no. 5, 2005, pp. 293-8.
Kokkonen L, Järvinen O, Majahalme S, et al. Atrial fibrillation in elderly patients after coronary artery bypass grafting; gender differences in outcome. Scand Cardiovasc J. 2005;39(5):293-8.
Kokkonen, L., Järvinen, O., Majahalme, S., Virtanen, V., Pehkonen, E., Mustonen, J., & Tarkka, M. (2005). Atrial fibrillation in elderly patients after coronary artery bypass grafting; gender differences in outcome. Scandinavian Cardiovascular Journal : SCJ, 39(5), 293-8.
Kokkonen L, et al. Atrial Fibrillation in Elderly Patients After Coronary Artery Bypass Grafting; Gender Differences in Outcome. Scand Cardiovasc J. 2005;39(5):293-8. PubMed PMID: 16269399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atrial fibrillation in elderly patients after coronary artery bypass grafting; gender differences in outcome. AU - Kokkonen,L, AU - Järvinen,O, AU - Majahalme,S, AU - Virtanen,V, AU - Pehkonen,E, AU - Mustonen,J, AU - Tarkka,M, PY - 2005/11/5/pubmed PY - 2006/1/28/medline PY - 2005/11/5/entrez SP - 293 EP - 8 JF - Scandinavian cardiovascular journal : SCJ JO - Scand Cardiovasc J VL - 39 IS - 5 N2 - OBJECTIVES: To evaluate gender-related differences in preoperative risk factors, hospital events, especially atrial fibrillation (AF), and length of stay in elderly patients undergoing isolated coronary artery bypass grafting (CABG). DESIGN: Prospectively collected data from consecutive patients undergoing isolated CABG in Tampere University Hospital between May 1999 and November 2000, in total 1131 patients. RESULT: We analysed 621 patients 65 years and older of whom 401 (65%) were male. When evaluating gender differences we found that the women were older (73 vs. 71 yrs, p<0.001) and significantly more often had hypertension (66% vs. 49%, p<0.001) and chronic heart insufficiency (11% vs. 4%, p=0.001). The NYHA classification of the women was worse (3.4 vs. 3.1, p<0.001) and in the angiographic data they had left main stenosis more often (31% vs. 21%, p=0.005) than the men. The women needed longer hospitalisation (19 vs. 15 days, p<0.001). There was no difference in the prevalence of postoperative AF between the genders, but in spite of that women had more postoperative strokes (6% vs. 3%, p=0.028) and also other major complications (29% vs. 19%, p=0.004) than the men. The 30-day mortality was higher in the female group (8% vs. 5%, p=0.06). We analysed preoperative risk factors and found that the females had a 1.6-fold risk for postoperative major complication after adjustment for age and other risk factors. In a logistic regression analysis age and the number of anastomoses emerged as independent predictors of AF in males, but in females we could not find any predictor for postoperative AF. CONCLUSIONS: The women are older and have more comorbidities and risk factors at the time of CABG. They also have more postoperative complications, but not a significantly higher mortality. Importantly, the excess of morbidity remains after adjustment for age and underlying risk factors. There is no gender difference in the incidence of postoperative AF in the elderly population. However, it seems to occur independent of age in the women only. SN - 1401-7431 UR - https://www.unboundmedicine.com/medline/citation/16269399/Atrial_fibrillation_in_elderly_patients_after_coronary_artery_bypass_grafting L2 - https://www.tandfonline.com/doi/full/10.1080/14017430510035934 DB - PRIME DP - Unbound Medicine ER -