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Postoperative atrial fibrillation is associated with late mortality after coronary surgery, but not after valvular surgery.
Ann Thorac Surg. 2009 Dec; 88(6):1871-6.AT

Abstract

BACKGROUND

Numerous studies have attempted to determine the etiology and prophylactic measures concerning atrial fibrillation (AF) after cardiac surgery. However, limited data are available analyzing the association between postoperative AF and late mortality. We sought to determine if AF after cardiac surgery affects postoperative survival.

METHODS

All cardiac surgery patients (n = 9,495) undergoing cardiac surgery between January 1994 and December 2004 were studied. The study population comprised coronary artery bypass graft surgery (CABG [n = 7,621]), valvular surgeries (n = 995), and their combination (n = 879). Patients affected by postoperative AF were identified, and long-term survival was obtained from Swedish population registry and evaluated using Cox proportional hazards methods to adjust for baseline differences.

RESULTS

The overall AF incidence was 26.7%, subdivided into 22.9%, 39.8%, and 45.2% for CABG, valve surgery, and combined procedures, respectively. The median follow-up for the entire study population was 7.9 years (maximum, 13.4). Postoperative AF independently affected long-term survival in CABG patients (hazard ratio 1.22; 95% confidence interval: 1.08 to 1.37). For isolated valvular surgery or combined procedures, AF was not significantly associated with long-term survival (hazard ratio 1.21, 95% confidence interval: 0.92 to 1.58; and hazard ratio 1.15, 95% confidence interval: 0.90 to 1.46, respectively).

CONCLUSIONS

Postoperative AF increases late mortality after isolated CABG surgery only. This finding was not statistically confirmed after isolated or combined valvular procedures. Our results draw the attention to possible AF recurrence after hospital discharge, indicating a strict postoperative surveillance.

Authors+Show Affiliations

Department of Surgical Sciences, Cardiac Surgery Unit, Varese University Hospital, Varese, Italy. giovannimariscalco@yahoo.itNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19932252

Citation

Mariscalco, Giovanni, and Karl Gunnar Engström. "Postoperative Atrial Fibrillation Is Associated With Late Mortality After Coronary Surgery, but Not After Valvular Surgery." The Annals of Thoracic Surgery, vol. 88, no. 6, 2009, pp. 1871-6.
Mariscalco G, Engström KG. Postoperative atrial fibrillation is associated with late mortality after coronary surgery, but not after valvular surgery. Ann Thorac Surg. 2009;88(6):1871-6.
Mariscalco, G., & Engström, K. G. (2009). Postoperative atrial fibrillation is associated with late mortality after coronary surgery, but not after valvular surgery. The Annals of Thoracic Surgery, 88(6), 1871-6. https://doi.org/10.1016/j.athoracsur.2009.07.074
Mariscalco G, Engström KG. Postoperative Atrial Fibrillation Is Associated With Late Mortality After Coronary Surgery, but Not After Valvular Surgery. Ann Thorac Surg. 2009;88(6):1871-6. PubMed PMID: 19932252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postoperative atrial fibrillation is associated with late mortality after coronary surgery, but not after valvular surgery. AU - Mariscalco,Giovanni, AU - Engström,Karl Gunnar, PY - 2009/05/03/received PY - 2009/07/22/revised PY - 2009/07/23/accepted PY - 2009/11/26/entrez PY - 2009/11/26/pubmed PY - 2010/1/6/medline SP - 1871 EP - 6 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 88 IS - 6 N2 - BACKGROUND: Numerous studies have attempted to determine the etiology and prophylactic measures concerning atrial fibrillation (AF) after cardiac surgery. However, limited data are available analyzing the association between postoperative AF and late mortality. We sought to determine if AF after cardiac surgery affects postoperative survival. METHODS: All cardiac surgery patients (n = 9,495) undergoing cardiac surgery between January 1994 and December 2004 were studied. The study population comprised coronary artery bypass graft surgery (CABG [n = 7,621]), valvular surgeries (n = 995), and their combination (n = 879). Patients affected by postoperative AF were identified, and long-term survival was obtained from Swedish population registry and evaluated using Cox proportional hazards methods to adjust for baseline differences. RESULTS: The overall AF incidence was 26.7%, subdivided into 22.9%, 39.8%, and 45.2% for CABG, valve surgery, and combined procedures, respectively. The median follow-up for the entire study population was 7.9 years (maximum, 13.4). Postoperative AF independently affected long-term survival in CABG patients (hazard ratio 1.22; 95% confidence interval: 1.08 to 1.37). For isolated valvular surgery or combined procedures, AF was not significantly associated with long-term survival (hazard ratio 1.21, 95% confidence interval: 0.92 to 1.58; and hazard ratio 1.15, 95% confidence interval: 0.90 to 1.46, respectively). CONCLUSIONS: Postoperative AF increases late mortality after isolated CABG surgery only. This finding was not statistically confirmed after isolated or combined valvular procedures. Our results draw the attention to possible AF recurrence after hospital discharge, indicating a strict postoperative surveillance. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/19932252/Postoperative_atrial_fibrillation_is_associated_with_late_mortality_after_coronary_surgery_but_not_after_valvular_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(09)01578-1 DB - PRIME DP - Unbound Medicine ER -