The impact of preoperative atrial fibrillation on early and late mortality after coronary artery bypass grafting

Bramer, Sander; Straten, Albert H.M. van; Hamad, Mohamed A. Soliman; Berreklouw, Eric; Martens, Elisabeth J.

doi:10.1016/j.ejcts.2010.02.017

Cited by 25 publications

(14 citation statements)

References 20 publications

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“…However, a similar relationship was not seen between the same group of patients and hospital mortality. [10] In a study by Bramer et al [11] in which the patients were enrolled for a longer period of time, it was determined that preoperative AF was an independent risk factor for hospital mortality in CABG patients. The incidence of AF in our study group was 24.5%, and the mortality rates between the two groups were not significantly different.…”

Section: Discussionmentioning

confidence: 99%

Coronary vasculature and postoperative atrial fibrillation: a risk factor analysis

Polat¹

2013

Turk Gogus Kalp Dama

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Bu çalışmada koroner arter baypas greft (KABG) ameliyatlarının sonuçları, ameliyat sonrası atriyal fibrilasyon, koroner damar yapısı ve koroner arter hastalığının şekli ve genişliği ile ilişkisi açısından incelendi. Ça lış mapla nı:Ocak 2011 ve Mayıs 2011 tarihleri arasında kliniğimizde ameliyat edilen ardışık 94 KABG hastası (68 erkek, 26 kadın; ort. yaş 61.4±10.9 yıl; aralık 38-87 yıl) bu prospektif gözlem çalışmasına alındı. Ameliyat sonrası atriyal fibrilasyon gelişimini etkileyen faktörler için lojistik regresyon analizi yapıldı. Bağımsız değişkenler olarak ameliyat sırası parametreler (Gensini skoru, Rentrop skoru, revaskülarize edilen damar sayısı, dominant koroner arter sistemi, dominant koroner arter sisteminin revaskülarizasyonu, sol ana koroner arter hastalığı, başvuru zamanı klinik tablosu, sol ventrikül disfonksiyonu ve sol atriyum çapı) analiz edildi. Bul gu lar: Ameliyat sırası 23 hastada (%24.5) atriyal fibrilasyon gelişti. Yirmi hasta amiodaron tedavisi ile normal sinüs ritmine döndürüldü. Üç hastada (%3.2) hastane mortalitesi oldu. Atriyal fibrilasyon gelişen ve gelişmeyen hastalarda mortalite oranları açısından istatistiksel olarak anlamlı bir fark yoktu. Sol ventrikül disfonksiyonu (p= 0.034) ve sol ana koroner arter hastalığı (p= 0.019) ameliyat sonrası atriyal fibrilasyon gelişimi ile anlamlı olarak ilişkiliydi. Renal komplikasyon oranı (p= 0.030) ve sternal revizyon cerrahisi gerekliliği (p= 0.003) açısından iki grup arasında anlamlı bir farklılık yoktu. So nuç:Ameliyat sonrası atriyal fibrilasyon kalp cerrahisinde sık karşılaşılan bir komplikasyondur. Sol ventrikül disfonksiyonu, ameliyat sonrası atriyal fibrilasyon gelişimi açısından anlamlı bir risk faktörüdür. Koroner damar yapısı ve atriyal fibrilasyon gelişimi arasında anlamlı bir ilişki olmasa da, sol ana koroner arter hastalığı ameliyat sonrası atriyal fibrilasyon için ciddi bir risk faktörüdür. Anah tar söz cük ler: Atriyal fibrilasyon; komplikasyon; koroner arter baypas greftleme; risk faktör. Background: This study aims to investigate the results of coronary artery bypass graft (CABG) surgeries in terms of the relation of postoperative atrial fibrillation, coronary vasculature, and the nature and extent of coronary artery disease. Methods: Between January 2011 and May 2011, 94 consecutive CABG patients (68 males, 26 females; mean age 61.4±10.9 years; range 38 to 87 years) who were operated in our clinic were enrolled in this prospective observational study. Logistic regression analysis was performed for the factors influencing the occurrence of postoperative atrial fibrillation. The perioperative parameters (Gensini score, Rentrop score, number of revascularized vessels, dominant coronary artery system, revascularization of the dominant coronary artery system, left main coronary artery disease, clinical status on admission, left ventricular dysfunction, and left atrium diameter) were analyzed as independent variables. Results: Twenty-three patients (24.5%) developed perioperative atrial fibrillation. Twenty patients returned to n...

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Section: Discussionmentioning

confidence: 99%

Coronary vasculature and postoperative atrial fibrillation: a risk factor analysis

Polat¹

2013

Turk Gogus Kalp Dama

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“…21 To this effect, AF could cause lethal stroke. AF can also have deleterious hemodynamic effect, which could contribute to an excess mortality rate.…”

Section: Impact Of Poaf On Operative Mortalitymentioning

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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“…3,4 The 30-day and 6-month mortality risk is increased 2-fold in patients who experience postoperative atrial fibrillation (POAF). 3,5 The extra time in the hospital and necessary interventions result in increased costs of approximately $10,000 per patient. 4 Some well-known risk factors for POAF after cardiac surgery include advanced age, increased atrial size, low blood serum electrolytes, and combined cardiac procedures, for example, valve repair plus coronary artery bypass grafting (CABG).…”

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confidence: 99%

A time-related parametric risk factor analysis for postoperative atrial fibrillation after heart surgery

Melby

George

Picone

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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The impact of preoperative atrial fibrillation on early and late mortality after coronary artery bypass grafting

Abstract: Preoperative AF is an independent risk factor for early and late mortality after first-time elective CABG.

Cited by 25 publications

References 20 publications

Coronary vasculature and postoperative atrial fibrillation: a risk factor analysis

Coronary vasculature and postoperative atrial fibrillation: a risk factor analysis

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

A time-related parametric risk factor analysis for postoperative atrial fibrillation after heart surgery

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