Abstract
Objective: To investigate the relationship between preoperative atrial fibrillation and early and late clinical outcomes following cardiac surgery. Methods: A retrospective cohort including all consecutive coronary artery bypass graft and/or valve surgery patients between 1995 and 2005 was identified (n = 9796). No patient had a concomitant surgical AF ablation. The association between preoperative atrial fibrillation and in-hospital outcomes was examined. We also determined late death and cardiovascular-related re-hospitalization by linking to administrative health databases. Median follow-up was 2.9 years (maximum 11 years). Results: The prevalence of preoperative atrial fibrillation was 11.3% (n = 1105), ranging from 7.2% in isolated CABG to 30% in valve surgery. In-hospital mortality, stroke, and renal failure were more common in atrial fibrillation patients (all p < 0.0001), although the association between atrial fibrillation and mortality was not statistically significant in multivariate logistic regression. Longitudinal analyses showed that preoperative atrial fibrillation was associated with decreased event-free survival (adjusted hazard ratio 1.55, 95% confidence interval 1.42-1.70, p < 0.0001). Conclusions: Preoperative atrial fibrillation is associated with increased late mortality and recurrent cardiovascular events post-cardiac surgery. Effective management strategies for atrial fibrillation need to be explored and may provide an opportunity to improve the long-term outcomes of cardiac surgical patients.
Original language | English |
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Pages (from-to) | 293-299 |
Number of pages | 7 |
Journal | European Journal of Cardio-thoracic Surgery |
Volume | 36 |
Issue number | 2 |
DOIs | |
Publication status | Published - Aug 2009 |
Bibliographical note
Funding Information:§ This work was supported by a Canadian Institutes of Health Research Team Grant in Cardiovascular Outcomes Research to the Canadian Cardiovascular Outcomes Research Team and a Department of Surgery Resident Research Grant, Dalhousie University. * Corresponding author. Address: Queen Elizabeth II Health Sciences Centre, 1796 Summer Street, Suite 2263, Halifax, Nova Scotia, Canada, B3H 3A7. Tel.: +1 902 473 3808; fax: +1 902 473 4448. E-mail address: imtiaz.ali@dal.ca (I.S. Ali).
ASJC Scopus Subject Areas
- Surgery
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine
PubMed: MeSH publication types
- Journal Article
- Research Support, Non-U.S. Gov't