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August 2, 2013Journal of Cardiac Surgery26 citations

The Impact of Postoperative Atrial Fibrillation and Race on Long-Term Survival after Coronary Artery Bypass Grafting

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WOWesley T. O’NealJEJimmy T. EfirdSDStephen W. Davies

Key Result

Black race was a significant predictor of decreased long-term survival among patients developing postoperative atrial fibrillation after CABG compared to white patients (adjusted HR 1.2; 95% CI 1.02-1.4).

Study Design

Type

Cohort (n=13,165)

Structured PICO

Does postoperative atrial fibrillation and race affect long-term survival in patients undergoing first-time isolated CABG?

P
Population
13,165 patients undergoing first-time, isolated CABG, followed for a median of 8.2 years.
E
Exposure
Postoperative atrial fibrillation (POAF) and Black race
C
Comparator
No postoperative atrial fibrillation, and White race with POAF
O
Outcome
Long-term survivalhard clinical

Black race is a significant predictor of decreased long-term survival among patients who develop postoperative atrial fibrillation after CABG.

Main Result

Hazard Ratio: 1.2 (95% CI 1.02–1.4)

Abstract

BACKGROUND AND AIM: Postoperative atrial fibrillation (POAF) is a known predictor of in-hospital morbidity and short-term survival after coronary artery bypass grafting (CABG). The impact of race and long-term survival has not been examined in this population. We aimed to examine the influence of these factors on long-term survival in patients undergoing CABG. METHODS: Patients undergoing first-time, isolated CABG between 1992 and 2011 were included in this study. Long-term survival was compared in patients with and without POAF and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model. RESULTS: A total of 2,907 (22%) patients developed POAF (black n=370; white n=2,537) following CABG (N=13,165). Median follow-up for study participants was 8.2 years. Long-term survival after CABG differed by POAF status and race (no POAF: HR=1.0; white POAF: adjusted HR=1.1, 95% CI=1.06-1.2; black POAF: adjusted HR=1.4, 95% CI=1.2-1.6; pTrend=0.0002). lack POAF patients also died sooner after surgery than their white counterparts (adjusted HR=1.2, 95% CI=1.02-1.4). CONCLUSION: Black race was a statistically significant predictor of decreased survival among POAF patients after CABG. This finding provides useful outcome information for surgeons and their patients.

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Cite This Study

O’Neal et al. (2013) conducted a cohort in Coronary Artery Bypass Grafting (CABG) (n=13,165). Black race among patients with postoperative atrial fibrillation vs. White race among patients with postoperative atrial fibrillation was evaluated on Long-term survival (HR 1.2, 95% CI 1.02-1.4). Black race was a significant predictor of decreased long-term survival among patients developing postoperative atrial fibrillation after CABG compared to white patients (adjusted HR 1.2; 95% CI 1.02-1.4).

synapsesocial.com/papers/6a6f2085f44fa9f079dc87bahttps://doi.org/10.1111/jocs.12178
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