Preoperative atrial fibrillation decreases event-free survival following cardiac surgery

Dimitri Kalavrouziotis, Karen J. Buth, Tarren Vyas, Imtiaz S. Ali

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)

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 languageEnglish
Pages (from-to)293-299
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume36
Issue number2
DOIs
Publication statusPublished - 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

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