TY  - BOOK
AU  - Thourani, Vinod H
TI  - Postcoronary Artery Bypass Graft Atrial Fibrillation Event Count and Survival: Differences by Sex
SN  - 0003-4975
PY  - 2020///
KW  - *Atrial Fibrillation/et [Etiology]
KW  - *Coronary Artery Bypass/ae [Adverse Effects]
KW  - *Coronary Artery Disease/su [Surgery]
KW  - *Postoperative Complications/ep [Epidemiology]
KW  - Aged
KW  - Atrial Fibrillation/ep [Epidemiology]
KW  - Electrocardiography
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Incidence
KW  - Male
KW  - Middle Aged
KW  - Prognosis
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Sex Distribution
KW  - Sex Factors
KW  - Survival Rate/td [Trends]
KW  - Time Factors
KW  - United States/ep [Epidemiology]
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N2  - BACKGROUND: New-onset post-coronary artery bypass graft surgery (CABG) atrial fibrillation (AF) is associated with poor outcomes, but data on the effects of its characteristics are lacking and conflicting. We examined the effect number of post-CABG AF events has on long-term mortality risk, and whether this is sex dependent; CONCLUSIONS: Both men and women who experienced >=2 post-CABG AF episodes showed increased risk of five-year mortality, independent of total AF duration. While men's risk increased as number of AF events increased, women's peaked at 2 AF events. Future research needs to determine whether this divergence stems from differences in treatment/management, or underlying biology. Copyright (c) 2019. Published by Elsevier Inc; METHODS: Routinely-collected Society of Thoracic Surgeons (STS) data were supplemented with details on new-onset post-CABG AF (detected in-hospital via continuous ECG/telemetry monitoring) and long-term survival for 9,203 consecutive isolated-CABG patients (2002-2010). Using Cox regression, we determined the propensity-adjusted (STS-recognized risk factors) effect of number of AF events on survival, testing for effect modification by sex and controlling for AF duration; RESULTS: AF occurred in 739 (29.4%) women and 2,157 (32.3%) men (p<0.001). Adjusted results showed >=2 AF events significantly (p<.0001) increased 5-year mortality risk, independently of total AF duration. However, mortality risk differed between the sexes (p<.0001): women with 2 AF episodes had the greatest increase (hazard ratio [HR]; 95% confidence interval [CI]: 2.98; 1.43,4.83, vs. women without AF), followed by women and men with >=4 AF events (HR; 95%CI: 2.76; 1.27,4.55 and 2.73; 2.30,3.19, respectively). A single post-CABG AF episode was not associated with increased mortality risk
UR  - https://dx.doi.org/10.1016/j.athoracsur.2019.08.098
ER  -