What is the clinical evidence from this study?

Study design: Cohort. Population: Degenerative mitral regurgitation (n=349). Intervention: Preoperative atrial fibrillation vs. Preoperative sinus rhythm. Primary outcome: 7-year survival (HR 2.70, 95% CI 1.09-6.68, p=0.03).

What question did this study set out to answer?

To determine the impact of preoperative atrial fibrillation on early and late clinical outcomes in patients undergoing mitral valve repair for degenerative mitral regurgitation.

February 6, 2007European Journal of Cardio-Thoracic Surgery

The effect of preoperative atrial fibrillation on survival following mitral valve repair for degenerative mitral regurgitation

Q: What does this research mean for the field?

Preoperative atrial fibrillation is associated with significantly lower early and late survival compared to sinus rhythm following mitral valve repair for degenerative mitral regurgitation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Preoperative atrial fibrillation was associated with significantly lower 7-year survival compared to sinus rhythm following mitral valve repair for degenerative mitral regurgitation (75% vs 90%; HR 2.70).

Why the study?

Does preoperative atrial fibrillation reduce survival in patients undergoing mitral valve repair for degenerative mitral regurgitation?

Population

349 patients undergoing various mitral valve repair procedures for degenerative mitral regurgitation between…

Comparison

Preoperative atrial fibrillation (AF) (n=152) vs Preoperative sinus rhythm (SR) (n=197)

Design

Cohort

Follow-up

7 years

Authors

CAChristos AlexiouInterventional / Structural Cardiology GDGeorge DoukasInterventional / Structural Cardiology MÖMehmet ÖçInterventional / Structural Cardiology

Discussion

Member takes

Implication

Preoperative AF signals higher mortality risk warranting closer surveillance; leaves open whether ablation improves survival after degenerative MR repair.

Key Points

To determine the impact of preoperative atrial fibrillation on early and late clinical outcomes in patients undergoing mitral valve repair for degenerative mitral regurgitation.
Retrospective cohort analysis of 349 patients undergoing mitral valve repair for degenerative mitral regurgitation between 1997 and 2003.
Patients were stratified into two cohorts based on baseline cardiac rhythm: preoperative atrial fibrillation (n=152, 44%) versus sinus rhythm (n=197, 56%).
Early morbidity, in-hospital mortality, valve re-operation rates, and 7-year survival were analyzed using Kaplan-Meier and Cox proportional hazards regression models.
Operative mortality was significantly higher in the atrial fibrillation group compared to the sinus rhythm group (3.9% vs 0.5%, p=0.04), alongside higher operative morbidity (27% vs 17%, p=0.03).
Seven-year Kaplan-Meier survival was 75±6% in the atrial fibrillation group compared with 90±3% in the sinus rhythm group (p=0.005).
Multivariable Cox regression confirmed preoperative atrial fibrillation as an independent adverse predictor of survival (HR 2.70, 95% CI 1.09–6.68, p=0.03), along with impaired left ventricular function (HR 0.25, 95% CI 0.078–0.84, p=0.02).

Study Design

Type

Cohort (n=349)

Structured PICO

Does preoperative atrial fibrillation reduce survival in patients undergoing mitral valve repair for degenerative mitral regurgitation?

Population

349 patients undergoing various mitral valve (MV) repair procedures for degenerative mitral regurgitation (MR) between 1997 and 2003

Intervention

Preoperative atrial fibrillation (AF) (n=152)

Comparator

Preoperative sinus rhythm (SR) (n=197)

Outcome

Early and late survivalhard clinical

Main Result

Effect estimate: HR 2.70 (95% CI 1.09-6.68)

Absolute Event Rate: 75% vs 90%

p-value: p=0.03

Preoperative atrial fibrillation is a significant adverse predictor of early and late survival in patients undergoing mitral valve repair for degenerative mitral regurgitation.

Cite This Study

Alexiou et al. (2007) conducted a cohort in Degenerative mitral regurgitation (n=349). Preoperative atrial fibrillation vs. Preoperative sinus rhythm was evaluated on 7-year survival (HR 2.70, 95% CI 1.09-6.68, p=0.03). Preoperative atrial fibrillation was associated with significantly lower 7-year survival compared to sinus rhythm following mitral valve repair for degenerative mitral regurgitation (75% vs 90%; HR 2.70).

synapsesocial.com/papers/6a1789df7afe20c06351e147 https://doi.org/10.1016/j.ejcts.2006.12.039

Topics

Mitral valve intervention Atrial fibrillation Persistent AF management AF ablation outcomes Anticoagulation in AF

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Implication

Preoperative AF signals higher mortality risk warranting closer surveillance; leaves open whether ablation improves survival after degenerative MR repair.

The effect of preoperative atrial fibrillation on survival following mitral valve repair for degenerative mitral regurgitation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

The effect of preoperative atrial fibrillation on survival following mitral valve repair for degenerative mitral regurgitation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider