Key result
Postoperative atrial fibrillation was independently associated with an increased risk of 1-year mortality (HR 2.86; 95% CI 1.05-7.75; p=0.038) following cardiac surgery.
Why the study?
This study was designed to assess the impact of postoperative atrial fibrillation on short- and long-term outcomes after cardiac surgery.
Does postoperative atrial fibrillation increase the risk of mortality and adverse events in adult patients undergoing cardiac surgery?
Cohort (n=379)
Yes
Does postoperative atrial fibrillation increase the risk of mortality and adverse events in adult patients undergoing cardiac surgery?
Hazard Ratio: 2.86 (95% CI 1.05–7.75)
p-value: p=0.038
Postoperative atrial fibrillation significantly increases the risk of 1-year mortality and major adverse cardiocerebral events following cardiac surgery, while discharge prescriptions of statins and beta-blockers are associated with reduced mortality.
POAF was associated with adverse post-cardiac surgery outcomes; hypothesis-generating for prevention trials before changing practice.
BACKGROUND: This study was designed to assess the impact of postoperative atrial fibrillation (POAF) on short- and long-term outcomes after cardiac surgery. METHODS: We prospectively assessed POAF concerning outcomes in 379 adult patients who had undergone cardiac surgery in two heart surgery centers with a follow-up period of one year for every patient. The effects of POAF on postoperative events were evaluated using Logistic regression, Cox regression (adjusted for propensity score), and Kaplan-Meier analysis. RESULTS: The incidence of POAF was 27.2%. Multivariable logistic regression analysis revealed POAF was associated with an increased risk of 6-month (OR = 5.36; CI: 1.51-18.94; p = 0.009), and 1-year mortality (OR = 4.56; CI: 1.29-16.04; p = 0.018) as well as Major Adverse Cardiocerebral Events (MACEs; acute MI, cardiac arrest, low cardiac output after surgery, third-degree atrioventricular block or stroke; OR = 3.02; CI: 1.29-7.05; p = 0.011), Intensive Care Unit (ICU) stay > 3 days (OR = 2.39; CI: 1.14-5.00; p = 0.021), and postoperative stay > 14 days (OR = 3.12; CI: 1.65-5.90; p < 0.001). Multivariable Cox regression analysis showed POAF as an independent predictor of mortality at one year (HR = 2.86; CI: 1.05-7.75; p = 0.038). Discharge plans including statin and beta-blocker had an independent association with a reduced mortality at one year (HR = 0.22; CI: 0.05-0.96; p = 0.045; HR = 0.16; CI: 0.03-0.87; p = 0.034, respectively). CONCLUSIONS: POAF is associated with an increased risk of morbidity, all-cause mortality, and hospital duration. Statins and beta-blockers that were included in discharge plans had an independent association with reduction in 1-year all-cause mortality.
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Hung et al. (2023) conducted a cohort in Postoperative atrial fibrillation after cardiac surgery (n=379). Postoperative atrial fibrillation (POAF) vs. No POAF was evaluated on 1-year mortality (HR 2.86, 95% CI 1.05-7.75, p=0.038). Postoperative atrial fibrillation was independently associated with an increased risk of 1-year mortality (HR 2.86; 95% CI 1.05-7.75; p=0.038) following cardiac surgery.
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