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New-onset postoperative atrial fibrillation after isolated coronary artery bypass graft surgery and long-term survival.
Circ Cardiovasc Qual Outcomes. 2009 May; 2(3):164-9.CC

Abstract

BACKGROUND

The advancing age and generally increasing risk profile of patients receiving isolated coronary artery bypass graft (CABG) surgery is expected to raise incidence of new-onset postoperative atrial fibrillation (AFIB) resulting in potentially higher risk of adverse outcomes. In the early postoperative course, new-onset post-CABG AFIB is considered relatively easy to treat and is believed to have little impact on patients' long-term outcome. However, little has been done to determine the effect of new-onset post-CABG AFIB on long-term survival, and this relationship is unclear.

METHODS AND RESULTS

Survival was assessed in a cohort of 6899 consecutive patients without preoperative AFIB who underwent isolated CABG at Baylor University Medical Center, Dallas, Tex, between January 1, 1997 and December 31, 2006; patients who died during CABG were excluded. Ten-year unadjusted survival was 52.3% (48.4%, 56.0%) for patients with new-onset postoperative AFIB and 69.4% (67.3%, 71.4%) for patients without it. A propensity-adjusted model controlling for risk factors identified by the Society of Thoracic Surgeons and other clinical/nonclinical details was used to investigate the association between new-onset AFIB post-CABG and long-term survival. After adjustment, new-onset AFIB post-CABG was significantly associated (hazard ratio, 1.29; 95% CI, 1.16, 1.45) with increased risk of death.

CONCLUSIONS

This study provides evidence that new-onset post-CABG AFIB is significantly associated with increased long-term risk of mortality independent of patient preoperative severity. After controlling for a comprehensive array of risk factors associated with post-CABG adverse outcomes, risk of long-term mortality in patients that developed new-onset post-CABG AFIB was 29% higher than in patients without it.

Authors+Show Affiliations

Institute for Health Care Research and Improvement, Baylor Research Institute, Dallas, Tex 76206, USA. giovanfi@baylorhealth.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20031833

Citation

Filardo, Giovanni, et al. "New-onset Postoperative Atrial Fibrillation After Isolated Coronary Artery Bypass Graft Surgery and Long-term Survival." Circulation. Cardiovascular Quality and Outcomes, vol. 2, no. 3, 2009, pp. 164-9.
Filardo G, Hamilton C, Hebeler RF, et al. New-onset postoperative atrial fibrillation after isolated coronary artery bypass graft surgery and long-term survival. Circ Cardiovasc Qual Outcomes. 2009;2(3):164-9.
Filardo, G., Hamilton, C., Hebeler, R. F., Hamman, B., & Grayburn, P. (2009). New-onset postoperative atrial fibrillation after isolated coronary artery bypass graft surgery and long-term survival. Circulation. Cardiovascular Quality and Outcomes, 2(3), 164-9. https://doi.org/10.1161/CIRCOUTCOMES.108.816843
Filardo G, et al. New-onset Postoperative Atrial Fibrillation After Isolated Coronary Artery Bypass Graft Surgery and Long-term Survival. Circ Cardiovasc Qual Outcomes. 2009;2(3):164-9. PubMed PMID: 20031833.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New-onset postoperative atrial fibrillation after isolated coronary artery bypass graft surgery and long-term survival. AU - Filardo,Giovanni, AU - Hamilton,Cody, AU - Hebeler,Robert F,Jr AU - Hamman,Baron, AU - Grayburn,Paul, Y1 - 2009/04/24/ PY - 2009/12/25/entrez PY - 2009/12/25/pubmed PY - 2010/3/27/medline SP - 164 EP - 9 JF - Circulation. Cardiovascular quality and outcomes JO - Circ Cardiovasc Qual Outcomes VL - 2 IS - 3 N2 - BACKGROUND: The advancing age and generally increasing risk profile of patients receiving isolated coronary artery bypass graft (CABG) surgery is expected to raise incidence of new-onset postoperative atrial fibrillation (AFIB) resulting in potentially higher risk of adverse outcomes. In the early postoperative course, new-onset post-CABG AFIB is considered relatively easy to treat and is believed to have little impact on patients' long-term outcome. However, little has been done to determine the effect of new-onset post-CABG AFIB on long-term survival, and this relationship is unclear. METHODS AND RESULTS: Survival was assessed in a cohort of 6899 consecutive patients without preoperative AFIB who underwent isolated CABG at Baylor University Medical Center, Dallas, Tex, between January 1, 1997 and December 31, 2006; patients who died during CABG were excluded. Ten-year unadjusted survival was 52.3% (48.4%, 56.0%) for patients with new-onset postoperative AFIB and 69.4% (67.3%, 71.4%) for patients without it. A propensity-adjusted model controlling for risk factors identified by the Society of Thoracic Surgeons and other clinical/nonclinical details was used to investigate the association between new-onset AFIB post-CABG and long-term survival. After adjustment, new-onset AFIB post-CABG was significantly associated (hazard ratio, 1.29; 95% CI, 1.16, 1.45) with increased risk of death. CONCLUSIONS: This study provides evidence that new-onset post-CABG AFIB is significantly associated with increased long-term risk of mortality independent of patient preoperative severity. After controlling for a comprehensive array of risk factors associated with post-CABG adverse outcomes, risk of long-term mortality in patients that developed new-onset post-CABG AFIB was 29% higher than in patients without it. SN - 1941-7705 UR - https://www.unboundmedicine.com/medline/citation/20031833/New_onset_postoperative_atrial_fibrillation_after_isolated_coronary_artery_bypass_graft_surgery_and_long_term_survival_ L2 - https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.108.816843?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -