https://orcid.org/0000-0002-6188-2137
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ABSTRACT
Background
This study was designed to assess the impact of postoperative atrial fibrillation (POAF) on short- and long-term outcomes after cardiac surgery.
Methods
We prospectively assessed POAF concerning outcomes in 379 adult patients who had undergone cardiac surgery in two heart surgery centers with a follow-up period of one year for every patient. The effects of POAF on postoperative events were evaluated using Logistic regression, Cox regression (adjusted for propensity score), and Kaplan-Meier analysis.
Results
The incidence of POAF was 27.2%. Multivariable logistic regression analysis revealed POAF was associated with an increased risk of 6-month (OR = 5.36; CI: 1.51–18.94; p = 0.009), and 1-year mortality (OR = 4.56; CI: 1.29–16.04; p = 0.018) as well as Major Adverse Cardiocerebral Events (MACEs; acute MI, cardiac arrest, low cardiac output after surgery, third-degree atrioventricular block or stroke; OR = 3.02; CI: 1.29–7.05; p = 0.011), Intensive Care Unit (ICU) stay > 3 days (OR = 2.39; CI: 1.14–5.00; p = 0.021), and postoperative stay > 14 days (OR = 3.12; CI: 1.65–5.90; p < 0.001). Multivariable Cox regression analysis showed POAF as an independent predictor of mortality at one year (HR = 2.86; CI: 1.05–7.75; p = 0.038). Discharge plans including statin and beta-blocker had an independent association with a reduced mortality at one year (HR = 0.22; CI: 0.05–0.96; p = 0.045; HR = 0.16; CI: 0.03–0.87; p = 0.034, respectively).
Conclusions
POAF is associated with an increased risk of morbidity, all-cause mortality, and hospital duration. Statins and beta-blockers that were included in discharge plans had an independent association with reduction in 1-year all-cause mortality.
Abbreviations
| AF | = | atrial fibrillation |
| BMI | = | Body Mass Index |
| CABG | = | Coronary Artery Bypass Graft |
| COPD | = | Chronic Obstructive Pulmonary Disease |
| CPB | = | CardioPulmonary Bypass |
| CI | = | Confidence Interval |
| CK-MB | = | Creatine Kinase Myocardial Band |
| cTn | = | Cardiac Troponin |
| ECG | = | ElectroCardioGram |
| EF | = | Ejection Fraction |
| HR | = | Hazard Ratio |
| ICU | = | Intensive Care Unit |
| LBBB | = | Left Bundle Branch Block |
| MACEs | = | Major Adverse Cardiocerebral Events |
| MI | = | Myocardial Infarction |
| NYHA | = | New York Heart Association |
| OR | = | Odds Ratio |
| POAF | = | Post Operative Atrial Fibrillation |
| PCI | = | Percutaneous Coronary Intervention |
| SD | = | Standard Deviation |
| ULN | = | Upper Limit of Normal |
Declaration of financial/other relationships
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers in this manuscript have no relevant financial or other relationships to disclose.