Postoperative atrial fibrillation following cardiac surgery was associated with significantly reduced five-year survival compared to normal sinus rhythm (83% vs. 93%, HR 2.63).
Cohort (n=744)
No
What are the risk factors for postoperative atrial fibrillation in patients undergoing open-heart surgery, and how does it impact survival?
Postoperative atrial fibrillation is common after open-heart surgery, particularly AVR, and is associated with increased operative mortality and reduced long-term survival.
Hazard Ratio: 2.63 (95% CI 1.76–3.93)
Absolute Event Rate: 83% vs 93%
p-value: p=<0.001
BACKGROUND: We studied potential risk factors for postoperative atrial fibrillation (POAF) in a large cohort of patients who underwent open-heart surgery, evaluating short- and long-term outcome, and we developed a risk-assessment model of POAF. METHODS: A retrospective study of 744 patients without prior history of AF who underwent CABG (n = 513), OPCAB (n = 207), and/or AVR (n = 156) at Landspitali Hospital in 2002-2006. Logistic regression analysis was used to study risk factors for POAF, comparing patients with and without POAF. RESULTS: The rate of POAF was 44%, and was higher following AVR (74%) than after CABG (44%) or OPCAB (35%). In general, patients with POAF were significantly older, were more often female, were less likely to be smokers, had a lower EF, and had a higher EuroSCORE. The use of antiarrythmics was similar in the groups but patients who experienced POAF were less likely to be taking statins. POAF patients also had longer hospital stay, higher rates of complications, and operative mortality (5% vs. 0.7%). In multivariate analysis, AVR (OR 4.4), a preoperative history of cardiac failure (OR 1.8), higher EuroSCORE (OR 1.1), and advanced age (OR 1.1) were independent prognostic factors for POAF. Overall five-year survival was 83% and 93% for patients with and without POAF (p <0.001). CONCLUSION: POAF was detected in 44% of patients, which is high compared to other studies. In the future, our assessment score will hopefully be of use in identifying patients at high risk of POAF and lower complications related to POAF.
Helgadóttir et al. (Wed,) conducted a cohort in Open-heart surgery (CABG, OPCAB, and/or AVR) without prior atrial fibrillation (n=744). Postoperative atrial fibrillation (POAF) vs. Normal sinus rhythm (NSR) was evaluated on Overall five-year survival (HR 2.63, 95% CI 1.76-3.93, p=<0.001). Postoperative atrial fibrillation following cardiac surgery was associated with significantly reduced five-year survival compared to normal sinus rhythm (83% vs. 93%, HR 2.63).