What does this research mean for the field?

Postoperative atrial fibrillation after coronary artery bypass grafting is a significant predictor of long-term newly developed atrial fibrillation and long-term mortality, with a markedly higher risk observed in females than in males. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2017Yonsei Medical JournalOpen Access

Gender Difference in the Long-Term Clinical Implications of New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Isolated coronary artery bypass graft (CABG) (n=1664). Intervention: Postoperative atrial fibrillation (POAF) vs. No postoperative atrial fibrillation (no-POAF). Primary outcome: Cumulative survival free of long-term (>1 year) newly developed atrial fibrillation (LTAF) in females (HR 16.50, 95% CI 4.79-56.78, p=<0.001).

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Key result

Postoperative atrial fibrillation after coronary artery bypass grafting was a significant predictor of long-term newly developed atrial fibrillation, with a markedly higher risk in females (HR 16.50) than in males (HR 4.91).

Why the study?

Does new-onset postoperative atrial fibrillation increase the risk of long-term atrial fibrillation and mortality differently in male versus female patients undergoing CABG?

Population

1,664 consecutive adult patients who underwent isolated coronary artery bypass graft surgery at a single…

Comparison

New-onset postoperative atrial fibrillation… vs No postoperative atrial fibrillation during the…

Design

Cohort

Follow-up

49±28 months

Authors

SLSeung‐Hyun LeeSeoul National University HLHancheol LeeNational Health Insurance Service Ilsan Hospital JPJin‐Kyu ParkEwha Womans University

Discussion

Member takes

Implication

POAF after CABG may signal greater long-term AF risk in women; extends sex-specific observations but remains hypothesis-generating pending prospective validation.

Study Design

Type

Cohort (n=1,664)

Multicenter

Structured PICO

Does new-onset postoperative atrial fibrillation increase the risk of long-term atrial fibrillation and mortality differently in male versus female patients undergoing CABG?

Population

1,664 consecutive adult patients (1,184 males, 480 females) who underwent isolated coronary artery bypass graft (CABG) surgery at a single center in Seoul, Korea. Mean age 63±9 (males) and 66±7 (females). Key exclusions: history of atrial fibrillation, emergency surgery, insufficient medical records, or death within 10 days after surgery.

Intervention

New-onset postoperative atrial fibrillation (POAF) documented using ECG or continuous monitoring during the first 10 days after surgery

Comparator

No postoperative atrial fibrillation (no-POAF) during the first 10 days after surgery

Outcome

Long-term (>1 year) newly developed atrial fibrillation (LTAF) and long-term mortality from any causehard clinical

Main Result

Effect estimate: HR 16.50 (95% CI 4.79-56.78)

Absolute Event Rate: 84.1% vs 98%

p-value: p=<0.001

Postoperative atrial fibrillation after CABG is a strong predictor of long-term atrial fibrillation in both sexes, but is significantly associated with long-term mortality only in women, highlighting the need for stricter surveillance in female patients.

Limitations

Propensity score matching reduced the number of patients included in the analyses, decreasing statistical power
Retrospective study design might have underestimated the prevalence of AF and other long-term complications
Older age of patients in the study could lead to bias as age affects AF incidence and mortality
POAF and other cardiovascular risk factors may not be completely independent
Retrospective cohort study design
Unmeasured confounding factors such as diet, exercise, and family history

Cite This Study

Lee et al. (2017) conducted a cohort in Isolated coronary artery bypass graft (CABG) (n=1,664). Postoperative atrial fibrillation (POAF) vs. No postoperative atrial fibrillation (no-POAF) was evaluated on Cumulative survival free of long-term (>1 year) newly developed atrial fibrillation (LTAF) in females (HR 16.50, 95% CI 4.79-56.78, p=<0.001). Postoperative atrial fibrillation after coronary artery bypass grafting was a significant predictor of long-term newly developed atrial fibrillation, with a markedly higher risk in females (HR 16.50) than in males (HR 4.91).

synapsesocial.com/papers/6a166304c0a26745e04c5709 https://doi.org/10.3349/ymj.2017.58.6.1119

Topics

Coronary artery disease Atrial fibrillation Persistent AF management AF ablation outcomes Anticoagulation in AF

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Implication

POAF after CABG may signal greater long-term AF risk in women; extends sex-specific observations but remains hypothesis-generating pending prospective validation.

Gender Difference in the Long-Term Clinical Implications of New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Gender Difference in the Long-Term Clinical Implications of New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider