Postoperative Atrial Fibrillation and Long-Term Risk of Stroke After Isolated Coronary Artery Bypass Graft Surgery | Zendy

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Postoperative Atrial Fibrillation and Long-Term Risk of Stroke After Isolated Coronary Artery Bypass Graft Surgery

Author(s) -

Umberto Benedetto,

Mario Gaudino,

Arnaldo Dimagli,

Stephen Gerry,

Alastair Gray,

Belinda Lees,

Marcus Flather,

David P. Taggart,

S Westaby,

Jo Cook,

C. Wallis,

Stanisław Woś,

Marek Jasiński,

Kazimierz Widenka,

Anna Błach,

Radosław Gocoł,

Damian Hudziak,

Paweł Żurek,

Marek Deja,

Ryszard Bachowski,

Roman Mrozek,

Tomasz Kargul,

W. Domarardzki,

Joanna Frąckiewicz,

Vipin Zamvar,

D. Ezakadan,

Brian Buxton,

Siven Seevanayagam,

George Matalanis,

A. Rosalion,

J. Negri,

Simon C. Moten,

Victoria Atkinson,

Andrew Newcomb,

P. Polidano,

Raluca Pana,

S. Gerbo,

Peter O’Keefe,

Ulrich Von Oppell,

Davendra Mehta,

A. Azzu,

Adam Szafranek,

E. Kulatilake,

J. D. Evans,

Niels D. Martin,

Davina Banner,

Uday Trivedi,

A. Forsyth,

Justeen Hyde,

A Cohen,

M. Lewis,

Eldon J. Gardner,

Adrian MacKenzie,

N. Cooter,

Eileen M. Joyce,

J. Parker,

F. Champney,

Stephen Clark,

John H. Dark,

K. Tocewicz,

Thillagavathie Pillay,

Susan E. Rowling,

Jennifer AdamsHall,

Andrzej Bochenek,

Marek Cisowski,

Maciej Bolkowski,

W Morawski,

M. Guć,

Michał Krejca,

Mirosław Wilczyński,

A. Duralek,

W. D. Gerber,

Janusz Skarysz,

R. Shrestha,

W. Świȩch,

Przemysław Szmagała,

Łukasz J. Krzych,

Agnieszka Pawlak,

K. Kepa,

Ragheb Hasan,

Daniel Keenan,

Bernard Prendergast,

N. Odom,

Kevin McLaughlin,

Gillian Cummings-Fosong,

Christopher G. Mathew,

Heather IlesSmith,

A. Oomen,

J. Desai,

A. ElGamel,

Lindsay C.H. John,

Olaf Wendler,

Michelle Andrews,

K. Rance,

Rhonda M. Williams,

V. Hogervorst,

John Gregory,

J. Jessup,

A. Knighton,

A M Hoare,

A. Ritchie,

CheeKeong Choong,

Sridevi Nair,

David J.A. Jenkins,

Stephen Large,

C. Sudarshan,

Manish Barman,

K. Dhital,

Tom Routledge,

Bruce R. Rosengard,

Helen Munday,

K. Rintoul,

E. Jarrett,

S. LaoSirieix,

A.J. Wilkinson,

L. Garner,

Jessica M. Osmond,

H. Holcombe,

Alexander R. Cale,

Susan Griffin,

J. A. Dickson,

Tomasz Spyt,

M. Hickey,

A. Sosnowski,

Giles J. Peek,

J. Szostek,

L. Hadjinikalaou,

Elaine Logtens,

MaryAnn Oakley,

S. Leji,

Jullien Gaer,

Mohamed Amrani,

Gilles Dreyfus,

Toufan Bahrami,

Kamran Baig,

George Asimakopoulos,

Hunaid A. Vohra,

V.S. Pai,

Soleimani S. Tadjkarimi,

G Stavri,

Glen Bull,

H. Collappen,

J. Sadowksi,

Bogusław Gawęda,

P. Rudziński,

Jarosław Stoliński,

Janusz KonstantyKalandyk,

Fernando Moraes,

Carlos R. Moraes,

J. Wanderley,

John Pepper,

Anthony De Souza,

Mario Petrou,

Richard Trimlett,

Tara A. Morgan,

J. Gavino,

S.F. Wang,

V. Chandrasekaran,

Robin Kanagasaby,

M. Sarsam,

H. Ryan,

L. Billings,

L. Ruddick,

A. Achampong,

E Förster,

Rafał Pawlaczyk,

Piotr Siondalski,

Jan Rogowski,

Krzysztof Roszak,

Krzysztof Jarmoszewicz,

Dariusz Jagielak,

S. Gafka,

Naguboyin G. Mannam,

LR Sajja,

B. Dandu,

Norman Briffa,

Peter Braidley,

Graham Cooper,

Katrina J. Allen,

Gurneet S. Sangha,

Christopher P. Bridge,

H. McMellon,

Riccardo Casabona,

Guglielmo Mario Actis Dato,

G. Bardi,

Forsennati S. Del Ponte,

Francesco Parisi,

Giuseppe Punta,

Roberto Flocco,

Fabrizio Sansone,

E. Zingarelli,

Walid C. Dihmis,

M. Kuduvali,

Camille Rince,

H. J. Rogers,

L. McQuade,

Lech Anisimowicz,

M. Bokszanski,

Wojciech Pawliszak,

Jan E. Kolakowski,

G. Lau,

Wojciech Ogorzeja,

I. Gumanska,

P. Kulinski,

Bruno K. Podesser,

Karola Trescher,

Oliver Y. Bernecker,

C Holzinger,

Konrad Binder,

I Schor,

Pierre Bergmann,

H. Kassal,

B. Motovova,

Naveen Trehan,

Zile Singh Meharwal,

Rajneesh Malhotra,

Mishita Goel,

B. Kumer,

S. Bazaz,

N. Bake,

Avneet Singh,

Y. Mishka,

Rajesh Gupta,

Subungshri Basumatary,

Michał Zembala,

Bartłomiej Szafron,

Jerzy Pacholewicz,

Marcin Krasoń,

Izabela Szymanik,

M. Kolwca,

Wojciech Mazur,

Arkadiusz Kurowicki,

Sławomir Żurek,

Tomasz Stącel,

Izabela Jaworska

Publication year - 2020

Publication title -

circulation

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 7.795

H-Index - 607

eISSN - 1524-4539

pISSN - 0009-7322

DOI - 10.1161/circulationaha.120.046940

Subject(s) - medicine , atrial fibrillation , cardiology , sinus rhythm , hazard ratio , stroke (engine) , post hoc analysis , population , complication , artery , proportional hazards model , surgery , confidence interval , mechanical engineering , environmental health , engineering

Background: Postoperative atrial fibrillation (pAF) after coronary artery bypass grafting is a common complication. Whether pAF is associated with an increased risk of cerebrovascular accident (CVA) remains uncertain. We investigated the association between pAF and long-term risk of CVA by performing a post hoc analysis of 10-year outcomes of the ART (Arterial Revascularization Trial). Methods: For the present analysis, among patients enrolled in the ART (n=3102), we excluded those who did not undergo surgery (n=25), had a history of atrial fibrillation (n=45), or had no information on the incidence of pAF (n=9). The final population consisted of 3023 patients, of whom 734 (24.3%) developed pAF with the remaining 2289 maintaining sinus rhythm. Competing risk and Cox regression analyses were used to investigate the association between pAF and the risk of CVA. Results: At 10 years, the cumulative incidence of CVA was 6.3% (4.6%–8.1%) versus 3.7% (2.9%–4.5%) in patients with pAF and sinus rhythm, respectively. pAF was an independent predictor of CVA at 10 years (hazard ratio, 1.53 [95% CI, 1.06–2.23];P =0.025) even when CVAs that occurred during the index admission were excluded from the analysis (hazard ratio, 1.47 [95% 1.02–2.11];P =0.04).Conclusions: Patients with pAF after coronary artery bypass grafting are at higher risk of CVA. These findings challenge the notion that pAF is a benign complication.

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