Predictors of Atrial Fibrillation After Coronary Artery Surgery

Aranki, Sary F.; Shaw, David P.; Adams, David H.; Rizzo, Robert J.; Couper, Gregory S.; VanderVliet, Martha; Collins, John J.; Cohn, Lawrence H.; Burstin, Helen

doi:10.1161/01.cir.94.3.390

Cited by 1,048 publications

(913 citation statements)

References 39 publications

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“…Moreover, early restoration of NSR is likely to decrease the lengthening and overall costs of hospitalization independently attributable to POAF. Aranky et al 34 reported a duration of hospitalization in patients with POAF an average of 3 to 4 days longer than in patients in NSR, which is on average 2 days more than that observed in the present study. Similar results were reported by other authors, with additional attributable costs associated with POAF ranging from $5,000 to $12,000 per patient.…”

contrasting

confidence: 66%

“…[31][32][33] In the present investigation, 62.6% of POAF patients were aged Ͼ70 years. Aranki et al 34 report an 18% incidence of POAF in patients aged Ͻ60 years versus 52% for those aged Ͼ80 years. The probability of developing POAF increases by about 25% for every 5-year increase in age, 32 with a plateau after 80 years.…”

Section: Atrial Fibrillation and Cardiac Surgery Discussionmentioning

confidence: 99%

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Atrial Fibrillation After Cardiac Surgery: Incidence, Risk Factors, and Economic Burden

Rostagno

Meir

Gelsomino

et al. 2010

Journal of Cardiothoracic and Vascular Anesthesia

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Objective: To evaluate the incidence of postoperative atrial fibrillation (POAF), the predisposing factors, the results of treatment before discharge, and the impact on duration and costs of hospitalization.Design: A prospective observational study. Conclusions: The overall incidence of POAF in the authors' center is close to 30%; 95.3% of patients were discharged in sinus rhythm. The increase in length and costs of hospitalization (on average, 1.0 day with a burden of about €1,800/ patient) were significantly lower than in previous investigations. Methods

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contrasting

confidence: 66%

Section: Atrial Fibrillation and Cardiac Surgery Discussionmentioning

confidence: 99%

Atrial Fibrillation After Cardiac Surgery: Incidence, Risk Factors, and Economic Burden

Rostagno

Meir

Gelsomino

et al. 2010

Journal of Cardiothoracic and Vascular Anesthesia

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“…2 However, conflicting results have been reported with regard to the impact of POAF on survival after cardiac surgery. 1,3 -12 Dr. Pibarot holds the Canada Research Chair in Valvular Heart Diseases, Canadian Institutes of Health Research.…”

Section: Introductionmentioning

confidence: 99%

Statins Reduce Short‐ and Long‐Term Mortality Associated With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: Impact of Postoperative Atrial Fibrillation and Statin Therapy on Survival

Girerd¹,

Daleau²,

Voisine

et al. 2012

Clinical Cardiology

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Background:Postoperative atrial fibrillation (POAF) is a frequent complication of coronary artery bypass grafting (CABG) surgery. The objective of this study was to determine the impact of POAF on both short‐ and long‐term mortality following isolated CABG.Hypothesis:POAF is associated with a poorer short and long‐term mortality following CABG.Methods:We retrospectively analyzed the preoperative and operative data of 6728 consecutive patients undergoing a first isolated CABG.Results:The incidence of POAF was 27.8%. Operative mortality was higher in patients with POAF compared to those without POAF (2.3% vs 0.9%, P < 0.001). On multivariate analysis, POAF remained an independent predictor of operative mortality (odds ratio [OR]: 1.78, P = 0.01). Patients with POAF also had reduced long‐term survival (6‐year survival: 85.3% vs 89.2%, P < 0.001). After adjusting for other predictors of mortality, POAF was significantly associated with increased long‐term mortality (hazard ratio [HR]: 1.35, P = 0.04). Of note, after adjustment for potential confounders, statin treatment had a highly protective effect in POAF patients for both operative mortality (OR: 0.38, P = 0.003) and long‐term mortality (HR: 0.62, P = 0.03), whereas it had no significant effect in patients without POAF.Conclusions:POAF is an independent predictor of both short‐ and long‐term mortality following CABG. Moreover, statin therapy was independently associated with better survival in patients with POAF.Dr. Pibarot holds the Canada Research Chair in Valvular Heart Diseases, Canadian Institutes of Health Research. Dr. Mathieu is a research scholar from the Fonds de Recherches en Santé du Québec, Montreal, Canada. Dr. Després has served as a speaker for Abbott Laboratories, AstraZeneca, Solvay Pharma, GlaxoSmithKline, and Pfizer Canada Inc.; has received research funding from Eli Lilly Canada; and has served on the advisory boards of Novartis, Theratechnologies, Torrent Pharmaceuticals Ltd., and Sanofi‐Aventis. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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“…[10] It typically occurs within the first four postoperative days. [11] Although numerous risk factors predisposing to PoAF development have been identified such as advanced age, anemia, hypoxia, left atrial dilatation, left ventricular dysfunction, severe CAD, hypertension, type of cardiac surgery, increased sympathetic activation, oxidative stress and inflammation, the main pathophysiology of PoAF has not been well-understood completely and it is likely multi-factorial in cause. [12][13][14] Postoperative complications including congestive heart failure, myocardial infarction, renal insufficiency, infection, prolonged ventilation and re-exploration of the chest for bleeding are also correlated with PoAF.…”

Section: Discussionmentioning

confidence: 99%

Validation of SYNTAX and clinical SYNTAX scores in predicting atrial fibrillation following on-pump coronary artery bypass grafting

Oktay¹

2017

Turk Gogus Kalp Dama

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Predictors of Atrial Fibrillation After Coronary Artery Surgery

Abstract: AF remains the most common complication after CABG and consequently is a drain on hospital resources. Concerted efforts to reduce the incidence of AF and the associated increased length of stay would result in substantial cost saving and decrease patient morbidity.

Cited by 1,048 publications

References 39 publications

Atrial Fibrillation After Cardiac Surgery: Incidence, Risk Factors, and Economic Burden

Atrial Fibrillation After Cardiac Surgery: Incidence, Risk Factors, and Economic Burden

Statins Reduce Short‐ and Long‐Term Mortality Associated With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: Impact of Postoperative Atrial Fibrillation and Statin Therapy on Survival

Validation of SYNTAX and clinical SYNTAX scores in predicting atrial fibrillation following on-pump coronary artery bypass grafting

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