Seung-Hyun Lee1, Dae Ryong Kang2, Jae-Sun Uhm1, Jaemin Shim1, Jung-Hoon Sung3, Jong-Youn Kim1, Hui-Nam Pak1, Moon-Hyoung Lee1, Boyoung Joung4. 1. Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Division of Cardiology, Department of Internal Medicine, Bundang CHA Medical Center, CHA University, Seongnam, Republic of Korea. 4. Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: cby6908@yuhs.ac.
Abstract
BACKGROUND: New-onset postoperative atrial fibrillation (POAF) is associated with poor short- and long-term outcomes after isolated coronary artery bypass graft (CABG). This study evaluated whether new-onset POAF is independently associated with long-term (>1 year) atrial fibrillation (AF) and mortality. METHODS: Among 1,171 consecutive patients who had undergone CABG, AF and mortality were compared between patients with POAF (POAF group, n = 244) and those without POAF (no-POAF group, n = 927) after propensity score matching. RESULTS: During the follow-up period of 41 ± 23 months (range 0-87 months), the POAF group had a higher incidence of total (20/927 [2.2%] vs 46/244 [18.9%], P < .001) and long-term AF recurrence (13/927 [1.4%] vs 25/244 [10.2%], P < .001). Even after propensity score matching, the POAF group still showed a higher incidence of total (7/244 [2.9%] vs 46/224 [18.9%], P < .001) and long-term AF recurrence (4/244 [1.6%] vs 25/224 [10.2%], P < .001). In addition, the POAF group had a lower cumulative survival free of long-term AF than the no-POAF group (P < .001). In competing risk regression, POAF was an independent predictor of long-term newly developed AF (hazard ratio 4.99, 95% CI 1.68-14.84, P = .004). Cumulative survival free of death was worse in patients with POAF (P = .01). CONCLUSIONS: New-onset POAF was shown to be a predictor of long-term newly developed AF in CABG patients. The results of this study suggest that patients who develop POAF should undergo strict surveillance and routine screening for AF during follow-up after surgery.
BACKGROUND: New-onset postoperative atrial fibrillation (POAF) is associated with poor short- and long-term outcomes after isolated coronary artery bypass graft (CABG). This study evaluated whether new-onset POAF is independently associated with long-term (>1 year) atrial fibrillation (AF) and mortality. METHODS: Among 1,171 consecutive patients who had undergone CABG, AF and mortality were compared between patients with POAF (POAF group, n = 244) and those without POAF (no-POAF group, n = 927) after propensity score matching. RESULTS: During the follow-up period of 41 ± 23 months (range 0-87 months), the POAF group had a higher incidence of total (20/927 [2.2%] vs 46/244 [18.9%], P < .001) and long-term AF recurrence (13/927 [1.4%] vs 25/244 [10.2%], P < .001). Even after propensity score matching, the POAF group still showed a higher incidence of total (7/244 [2.9%] vs 46/224 [18.9%], P < .001) and long-term AF recurrence (4/244 [1.6%] vs 25/224 [10.2%], P < .001). In addition, the POAF group had a lower cumulative survival free of long-term AF than the no-POAF group (P < .001). In competing risk regression, POAF was an independent predictor of long-term newly developed AF (hazard ratio 4.99, 95% CI 1.68-14.84, P = .004). Cumulative survival free of death was worse in patients with POAF (P = .01). CONCLUSIONS: New-onset POAF was shown to be a predictor of long-term newly developed AF in CABG patients. The results of this study suggest that patients who develop POAF should undergo strict surveillance and routine screening for AF during follow-up after surgery.
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