Transient post-operative atrial fibrillation following first-time isolated CABG was independently associated with a significantly increased risk of all-cause mortality at 1 year (HR 1.89).
Cohort (n=5,135)
No
Does transient post-operative atrial fibrillation increase the risk of death, MI, or stroke at 1 year in patients undergoing first time, isolated CABG?
Transient post-operative atrial fibrillation following first-time isolated CABG is an independent predictor of 1-year all-cause mortality.
Hazard Ratio: 1.89 (95% CI 1.42–2.53)
Absolute Event Rate: 6.4% vs 2.7%
p-value: p=<0.001
OBJECTIVE: To assess the relationship between the development of transient post-operative atrial fibrillation (TPOAF) following coronary artery bypass graft (CABG) surgery and risk of long-term mortality. BACKGROUND: Atrial fibrillation (AF) following CABG is common and associated with increased morbidity and mortality in the perioperative period. However the impact of TPOAF and its management on long-term morbidity and mortality in patients undergoing first time, isolated CABG surgery remains unclear. METHODS: The Cleveland Clinic Cardiovascular Information Registry was used to identify 5,205 consecutive patients who underwent CABG between January 1993 and December 2005. Patients with TPOAF (n=1,490) were compared to those without post-operative AF (n=3,645) for the endpoints of death, myocardial infarction (MI), or stroke at 1 year. RESULTS: Overall rates of 1-year mortality, MI and stroke were 3.7%, 0.8%, and 2.6%, respectively. Patients with TPOAF had an increased risk of death at 1 year as compared to patients without POAF (6.4% vs. 2.7%; P<0.001), but there was not an increased risk of stroke or MI. Multivariate analysis identified TPOAF as an independent predictor of death at 1 year (HR 1.89, 95% CI, 1.42-2.53; P<0.001). After propensity matching, patients who developed TPOAF experienced a significantly increased risk of death compared with those without TPOAF (HR 1.96, 95% CI, 1.34-2.86; P<0.001). CONCLUSIONS: In patients undergoing first time, isolated CABG, the presence of TPOAF identifies a subgroup of patients at increased risk for all-cause mortality. Future prospective studies to determine potential beneficial interventions in this large population are warranted.
Philip et al. (2014) conducted a cohort in First-time, isolated coronary artery bypass graft (CABG) surgery (n=5,135). Transient post-operative atrial fibrillation (TPOAF) vs. No post-operative atrial fibrillation was evaluated on All-cause mortality at 1 year (HR 1.89, 95% CI 1.42-2.53, p=<0.001). Transient post-operative atrial fibrillation following first-time isolated CABG was independently associated with a significantly increased risk of all-cause mortality at 1 year (HR 1.89).