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Postoperative atrial fibrillation: Sex-specific characteristics and effect on survival.

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Citation: Journal of Thoracic & Cardiovascular Surgery. 159(4):1419-1425.e1, 2020 04.PMID: 31208806Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Observational StudySubject headings: *Atrial Fibrillation/ep [Epidemiology] | *Coronary Artery Bypass/ae [Adverse Effects] | *Coronary Artery Disease/su [Surgery] | *Postoperative Complications/ep [Epidemiology] | Aged | Cohort Studies | Coronary Artery Disease/co [Complications] | Coronary Artery Disease/mo [Mortality] | Female | Humans | Incidence | Male | Middle Aged | Sex Factors | Survival RateYear: 2020 Local holdings: Available online from MWHC library: 1994 - present, Available in print through MWHC library: 1999 - 2006ISSN:

0022-5223

Name of journal: The Journal of thoracic and cardiovascular surgeryAbstract: BACKGROUND: We sought to fill important gaps in the existing evidence regarding new-onset atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG) by comparing the incidence, characteristics, and effect on long-term survival between men and women.CONCLUSIONS: In our study, women had lower adjusted risk of post-CABG AF and experienced shorter episodes. The adjusted risk of long-term mortality was 56% greater among patients who developed post-CABG AF compared with those who did not. The effect of post-CABG AF on long-term survival did not differ between the sexes. Copyright (c) 2019. Published by Elsevier Inc.METHODS: Nine thousand two hundred three consecutive patients without preoperative AF underwent isolated CABG from 2002 to 2010 at 3 US academic medical centers and 1 high-volume specialty cardiac hospital. Detailed data on CABG AF events detected via continuous in-hospital electrocardiogram/telemetry monitoring were supplemented with Society of Thoracic Surgeons data, and survival data, censored at October 31, 2011, using a copy of the Social Security Death Master File archived before state-owned data were removed (November 1, 2011).RESULTS: Propensity-adjusted (Society of Thoracic Surgeons-recognized risk factors) incidence of post-CABG AF was 31.5% overall, 32.8% in men, and 27.4% in women. Over the 9-year study period, women had a significantly lower risk of post-CABG AF (absolute difference, -5.3% [95% confidence interval (CI), -10.5% to -0.6%]), and significantly shorter first (-2.9 hours; 95% CI, -5.8 to 0.0), and longest (-4.3 hours; 95% CI, -8.3 to -0.3) AF duration. Post-CABG AF was associated with significantly increased risk of long-term mortality (overall hazard ratio [HR], 1.56; 95% CI, 1.45-1.67; men HR, 1.57; 95% CI, 1.49-1.65; women HR, 1.54; 95% CI, 1.14-2.07).All authors: Ailawadi G, da Graca B, Damiano RJ Jr, Filardo G, Phan TK, Pollock BD, Thourani VOriginally published: Journal of Thoracic & Cardiovascular Surgery. 159(4):1419-1425.e1, 2020 04.Fiscal year: FY2020Digital Object Identifier:

https://dx.doi.org/10.1016/j.jtcvs.2019.04.097

Date added to catalog: 2020-07-09

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	31208806	Available		31208806

Available online from MWHC library: 1994 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: We sought to fill important gaps in the existing evidence regarding new-onset atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG) by comparing the incidence, characteristics, and effect on long-term survival between men and women.

CONCLUSIONS: In our study, women had lower adjusted risk of post-CABG AF and experienced shorter episodes. The adjusted risk of long-term mortality was 56% greater among patients who developed post-CABG AF compared with those who did not. The effect of post-CABG AF on long-term survival did not differ between the sexes. Copyright (c) 2019. Published by Elsevier Inc.

METHODS: Nine thousand two hundred three consecutive patients without preoperative AF underwent isolated CABG from 2002 to 2010 at 3 US academic medical centers and 1 high-volume specialty cardiac hospital. Detailed data on CABG AF events detected via continuous in-hospital electrocardiogram/telemetry monitoring were supplemented with Society of Thoracic Surgeons data, and survival data, censored at October 31, 2011, using a copy of the Social Security Death Master File archived before state-owned data were removed (November 1, 2011).

RESULTS: Propensity-adjusted (Society of Thoracic Surgeons-recognized risk factors) incidence of post-CABG AF was 31.5% overall, 32.8% in men, and 27.4% in women. Over the 9-year study period, women had a significantly lower risk of post-CABG AF (absolute difference, -5.3% [95% confidence interval (CI), -10.5% to -0.6%]), and significantly shorter first (-2.9 hours; 95% CI, -5.8 to 0.0), and longest (-4.3 hours; 95% CI, -8.3 to -0.3) AF duration. Post-CABG AF was associated with significantly increased risk of long-term mortality (overall hazard ratio [HR], 1.56; 95% CI, 1.45-1.67; men HR, 1.57; 95% CI, 1.49-1.65; women HR, 1.54; 95% CI, 1.14-2.07).

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