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

Medientyp: E-Artikel
Titel: Postoperative Atrial Fibrillation and Long-Term Risk of Stroke After Isolated Coronary Artery Bypass Graft Surgery
Beteiligte: Benedetto, Umberto; Gaudino, Mario F.; Dimagli, Arnaldo; Gerry, Stephen; Gray, Alastair; Lees, Belinda; Flather, Marcus; Taggart, David P.; Westaby, S.; Cook, J.; Wallis, C.; Wos, S.; Jasinski, M.; Widenka, K.; Blach, A.; Gocol, R.; Hudziak, D.; Zurek, P.; Deja, M.; Bachowski, R.; Mrozek, R.; Kargul, T.; Domarardzki, W.; Frackiewicz, J.; [...]
Erschienen: Ovid Technologies (Wolters Kluwer Health), 2020
Erschienen in: Circulation
Sprache: Englisch
DOI: 10.1161/circulationaha.120.046940
ISSN: 0009-7322; 1524-4539
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Beschreibung: <jats:sec> <jats:title>Background:</jats:title> <jats:p>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).</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> 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]; <jats:italic>P</jats:italic> =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]; <jats:italic>P</jats:italic> =0.04). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>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.</jats:p> </jats:sec>
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