The Impact of New-Onset Postoperative Atrial Fibrillation on Mortality After Coronary Artery Bypass Grafting

摘要

PatientsDefinitionsOperative Technique and Postoperative PolicyStatistical AnalysisResultsEarly MortalityLate MortalityOverall MortalityCommentEarly MortalityOverall and Late MortalityReferencesNew-onset postoperative atrial fibrillation (POAF) is a frequent rhythm disturbance after coronary artery bypass grafting (CABG). This study investigated the independent effect of POAF on early and late mortality after isolated CABG.MethodsData of patients who consecutively underwent isolated CABG between January 2003 and December 2007 were prospectively collected. The analysis included 5098 patients with preoperative sinus rhythm and no history of atrial fibrillation. Logistic regression analysis for early mortality and Cox regression analysis for late mortality were performed. Propensity score matching was performed to eliminate the effect of confounders.ResultsMedian follow-up was 2.5 years. POAF was documented in 1122 patients (22.0%). Early mortality was more frequent in POAF patients (3.1%) vs non-POAF patients (1.6%, p = 0.002), but multivariate logistic regression analysis could not identify POAF as an independent predictor of early mortality (p = 0.169). This outcome did not change after adjusting for quintiles of the propensity score of POAF (p = 0.100). Multivariate Cox proportional hazard analyses demonstrated POAF was an independent predictor of overall and late mortality with hazard ratios of 1.35 (p = 0.012 and p = 0.039, respectively). Analyses after propensity score matching showed that patients with POAF had similar hazard ratios of 1.36 for overall mortality and 1.34 for late mortality (p = 0.009 and p = 0.042, respectively).ConclusionsPOAF is an independent predictor of overall and late mortality after isolated CABG but not of early mortality.CTSNet classification:24ADULT CARDIAC SURGERYThe Annals of Thoracic Surgery CME Program is located online at http://cme.ctsnetjournals.org. To take the CME activity related to this article, you must have either an STS member or an individual non-member subscription to the journal.New-onset postoperative atrial fibrillation (POAF) is observed in about 20% to 40% of patients undergoing coronary artery bypass grafting (CABG) [