The overall incidence of POAF following CABG was 24%, and beta-blocker non-use or withdrawal significantly increased the odds of developing POAF (OR 2.26; 95% CI 1.35-3.78; p<0.01).
Meta-Analysis (n=180,223)
What is the incidence and what are the predictors of postoperative atrial fibrillation following CABG surgery?
Postoperative atrial fibrillation occurs in approximately 24% of patients following CABG, with several identifiable clinical and surgical predictors that can help stratify high-risk patients for preventive measures.
Odds Ratio: 2.26 (95% CI 1.35–3.78)
p-value: p=<0.01
Background Postoperative atrial fibrillation (POAF) is one of the most common tachyarrhythmias after coronary artery bypass graft (CABG) surgery. This study aimed to determine the overall incidence and predictors of POAF after CABG surgery through a systematic review of existing research findings.Methods The protocol of this study was registered in PROSPERO (CRD420251023423) and written under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results 207 articles with a total sample size of 180,223 participants were included in our meta-analysis. The overall incidence of POAF following CABG surgery was 24% (95% CI 23%–26%). Increased age and male gender were associated with higher odds of developing POAF (ORs of 1.06 and 1.28, respectively, p < 0.01). Comorbidities, including congestive heart failure (CHF), hypertension, COPD, renal failure, and chronic kidney disease (CKD), were shown to be predictors of POAF. Those who do not use beta-blocker or have withdrawn from it were more likely to experience POAF (OR = 2.26, 95% CI 1.35–3.78, p < 0.01). Preoperative use of statins significantly reduced the odds of POAF (OR = 0.57, 95% CI 0.42–0.78, p < 0.01). On-pump surgery, grafting ≥ 3 vessels, longer length of stay in hospital, use of intra-aortic balloon pump (IABP), prolonged cross-clamp time, use of inotropic medications, and higher left atrial volume index (LAVI), and LA diameter were also predictors of POAF. Higher preoperative left ventricular ejection fraction (LVEF) was another factor that was associated with lower odds of developing POAF.Conclusion Recognising the risk factors for POAF helps us to identify high-risk patients to provide better preventive measures and management strategies for POAF after CABG.
Farzaneh et al. (Thu,) conducted a meta-analysis in Postoperative atrial fibrillation after CABG surgery (n=180,223). Beta-blocker non-use or withdrawal vs. Beta-blocker use was evaluated on Postoperative atrial fibrillation (POAF) (OR 2.26, 95% CI 1.35-3.78, p=<0.01). The overall incidence of POAF following CABG was 24%, and beta-blocker non-use or withdrawal significantly increased the odds of developing POAF (OR 2.26; 95% CI 1.35-3.78; p<0.01).
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