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New Onset Postoperative Atrial Fibrillation is Associated with a Long‐Term Risk for Stroke and Death Following Cardiac Surgery
Author(s) -
Horwich Peter,
Buth Karen J.,
Légaré JeanFrancois
Publication year - 2013
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12033
Subject(s) - medicine , atrial fibrillation , stroke (engine) , hazard ratio , proportional hazards model , cardiology , cardiac surgery , surgery , confidence interval , mechanical engineering , engineering
Background and aim: We sought to evaluate the long‐term impact of post‐cardiac surgery atrial fibrillation on the risk of stroke and survival. Methods: Patients undergoing isolated CABG surgery from April 1, 1995 to March 31, 2007 were identified ( n = 8058). Long‐term stroke data were compiled using Cox modeling adjusted for clinical characteristics comparing patients with new‐onset atrial fibrillation (NwAfib) and those without. Results: NwAfib developed in 2214 patients (27.5%). Overall in‐hospital mortality was 2.4% and was not different between groups. Unadjusted in‐hospital outcomes suggest patients with NwAfib were more likely to suffer a permanent stroke (1% vs 2.5%; p < 0.001) require prolonged mechanical ventilation ( p < 0.001) and prolonged stay in hospital ( p < 0.001). After discharge patients were followed for a mean of 5.7 years. Stroke was reported in 268 (12.1%) patients in the NwAfib group compared to others (8.4%). After adjustment NwAfib was independently associated with a higher risk for stroke with a hazard ratio of 1.26 (1.08–1.47; p = 0.0034) and a higher risk of death with a hazard ratio of 1.2 (1.08–1.32; p = 0.0007). Conclusions: Patients with NwAfib perioperatively have increased risk of stroke and early death after discharge independent of other clinical risk factors.