Racial Differences in the Incidence and Outcomes of Postoperative Atrial Fibrillation After Isolated Coronary Artery Bypass Grafting: A Systematic Review

Postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG), with an estimated incidence of up to 20% to 40%. Existing evidence suggests that inequities in access to health care may impact clinical outcomes following POAF. This systematic review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines across the Cochrane, MEDLINE, and Embase databases to retrieve potential studies. Studies reporting racial and/or socioeconomic differences in the incidence or outcomes of new-onset POAF after isolated CABG were included. Title and abstract screening and full-text review were performed using Covidence software for systematic reviews. The risk of bias was assessed using the JBI Critical Appraisal Tool. The search strategy retrieved 1,155 studies. After duplicate removal, 1,149 studies underwent the screening process. Eventually, 6 studies were included for data extraction. The results showed a higher reported incidence of POAF among White patients than among African American and other racial and ethnic groups. However, African American patients appear to have worse survival after developing POAF. Income, education, insurance status, and other socioeconomic or access-to-care variables were not consistently reported or adjusted for in the included studies. Racial differences can impact the incidence and clinical outcomes in patients who develop POAF after CABG. Future work could investigate the role of other socioeconomic factors.