Key result
Blood transfusion in adult patients undergoing coronary artery bypass grafting surgery was associated with a significantly increased risk of developing postoperative atrial fibrillation (OR 1.45).
Why the study?
Does blood transfusion increase the risk of postoperative new-onset atrial fibrillation in adult patients undergoing CABG surgery?
Meta-Analysis (n=31,069)
Does blood transfusion increase the risk of postoperative new-onset atrial fibrillation in adult patients undergoing CABG surgery?
Blood transfusion during or after CABG surgery is associated with a significantly increased risk of postoperative new-onset atrial fibrillation.
May warrant caution with transfusions in CABG; leaves open whether the association is causal.
The aim of this study was to systematically evaluate the effect of blood transfusion (BT) on postoperative atrial fibrillation (AF) in adult patients who had undergone coronary artery bypass grafting (CABG) surgery.PubMed, Embase, and Cochrane Library databases from inception to January 2017 were searched. Cohort studies were searched that evaluated the association between BT and the risk of postoperative AF in adult patients who had undergone CABG surgery. Study quality was assessed by using the Newcastle-Ottawa scale (NOS). A meta-analysis was performed with the random-effect model.Eight cohort studies involving 7401 AF cases and 31,069 participants were identified and included in our data analysis. The pooled odds ratio of postoperative AF in patients with BT was 1.45 (95% confidence interval, 1.26-1.67), with significant heterogeneity (P < .0001, I = 79%). Excluding one study that had an off-pump CABG did not significantly impact this result (odds ratio, 1.36; 95% confidence interval, 1.23-1.50; n = 7). To examine the stability of the primary results, we performed subgroup analyses. The association between BT and the risk of postoperative AF was similar, as determined in the stratified analyses conducted according to study design, type of surgery, and country.The findings of the present meta-analysis demonstrated a statistically significant increase in postoperative AF risk among adult patients with BT. Further prospective large-scale studies are needed to establish causality and to elucidate the underlying mechanisms.
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Liu et al. (2018) conducted a meta-analysis in Postoperative atrial fibrillation after CABG surgery (n=31,069). Blood transfusion vs. No blood transfusion was evaluated on Postoperative atrial fibrillation (OR 1.45, 95% CI 1.26-1.67, p=<0.00001). Blood transfusion in adult patients undergoing coronary artery bypass grafting surgery was associated with a significantly increased risk of developing postoperative atrial fibrillation (OR 1.45).
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