New onset postoperative atrial fibrillation predicts long-term cardiovascular events after gastrectomy

Abstract

Background Recent evidence suggests transient postoperative atrial fibrillation leads to future cardiovascular events, even in noncardiac surgery. The long-term effects of postoperative atrial fibrillation in gastrectomy patients are unknown. Methods The Healthcare Cost and Utilization Project State Inpatient Databases identified patients undergoing gastrectomy for malignancy between 2007 and 2010. Patients were matched by propensity scores based on various factors. Adjusted Kaplan-Meier and Cox proportional hazards models assessed the effect of postoperative atrial fibrillation on cardiovascular events. Results A higher incidence of cardiovascular events occurred over the 1st year in patients who developed postoperative atrial fibrillation. Cox proportional hazards regression confirmed an increased risk of cardiovascular events in postoperative atrial fibrillation patients. Conclusions Our results demonstrate that patients undergoing gastrectomy for malignancy who develop postoperative atrial fibrillation are at increased risk of cardiovascular events within 1 year. Physicians should be vigilant in assessing postoperative atrial fibrillation, given the increased risk of cardiovascular morbidity.

Pathophysiologic Peculiarities of Different Factors’ Influence on Development and Course of IHD Complicated with Atrial Fibrillation

“…Correlation between IHD and NAFLD was studied not only in Europe; Indian scientists have also analyzed content of serum transaminases, plasminogen activator inhibitor (PAI-I), C-reactive protein, tumor necrosis factorα in 149 patients diagnosed with IHD in 2007-2009. They made conclusions that the revealed changes reflect anti-inflammatory status in patients with NAFLD that creates preconditions for IHD development [14].…”

“…4. Having analyzed literature sources, it is possible to claim that fatty liver dystrophy, steatohepatosis are independent risk factors for CVD because a close connection between them and dyslipidemia and insulin resistance was proved [13,14]. A search for common mechanisms of IHD complicated with AF development with functional liver failure remains an actual task for the modern medicine.…”

Self-monitoring for recurrence of secondary atrial fibrillation following non-cardiac surgery or acute illness: A pilot study

“…Patients with secondary AF after non-cardiac surgery have an approximately 5-fold increased risk of ischaemic stroke and myocardial infarction, with approximately 2.5 fold increase in death within 1-year of surgery [4] , [7] , [10] . In fact, stroke risk is significantly higher for people with AF after non-cardiac compared to cardiac surgery (HR 2.0 vs 1.3 p < 0.001) [4] .…”

“…Secondary AF also occurs after ~1% of non-cardiac surgical procedures [4] , equating to > 2 million cases of secondary AF per year given the large numbers of these procedures performed worldwide [5] . The incidence of secondary AF is higher following procedures such as abdominal surgery (11%) [6] or gastrectomy for cancer (8%) [7] .…”

Impact and treatment success of new-onset atrial fibrillation with rapid ventricular rate development in the surgical intensive care unit

“…In all surgical patients (ICU and non-ICU), POAF after non-cardiac surgery has been associated with mortality of 12% 15 to 37.5% 16131 . In addition, if the patient does survive their hospitalization, a new diagnosis of AF following surgery has been associated with a 3 fold increased risk of a cardiovascular event following gastrectomy 17 and radical cystectomy 4 and a 13 month decrease in long term survival following esophagectomy 18 . Given the high rate of cardiac co-morbidities in these patients (Table 1) and the catecholamine surges associated with surgery and sepsis, the development of POAF is probably a harbinger of impending cardiac complications.…”