Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12295
Title: Preoperative atrial fibrillation is an independent predictor of worse early and late outcomes after isolated coronary artery bypass graft surgery.
Authors: Saxena, Akshat;Kapoor, Jada;Dinh, Diem T;Smith, Julian A;Shardey, Gilbert C;Newcomb, Andrew E
Affiliation: Department of Cardiothoracic Surgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Department of Surgery, Austin Hospital, Heidelberg, Victoria, Australia.
Department of Epidemiology and Preventative Medicine, Monash University, Prahran, Victoria, Australia.
Department of Surgery (MMC), Monash University, Clayton, Victoria, Australia; Department of Cardiothoracic Surgery, Monash Medical Centre, Clayton, Victoria, Australia.
Cabrini Medical Centre, Malvern, Victoria, Australia.
Department of Cardiothoracic Surgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; University of Melbourne, Department of Surgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia. Electronic address: andrew.newcomb@svhm.org.au.
Issue Date: 3-Jul-2014
Citation: Journal of Cardiology 2014; 65(3): 224-9
Abstract: To evaluate the impact of preoperative atrial fibrillation (pre-op AF) on early and late mortality after isolated coronary artery bypass graft (CABG) surgery.Data obtained prospectively between June 2001 and December 2009 by the Australasian Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database Program were retrospectively analyzed. Patients who underwent concomitant atrial arrhythmia surgery/ablation were excluded. Demographic and operative data were compared between patients with and without pre-op AF. The independent association of pre-op AF on early mortality, perioperative complications, and late mortality was determined.Isolated CABG surgery was performed in 21,534 patients; 1312 (6.1%) presented with pre-op AF. Pre-op AF patients were older (mean age, 71 years vs. 65 years, p<0.001) and had more comorbidities reflected in a higher additive EuroSCORE (8.4±3.5 vs. 6.5±3.2, p=0.001). Even after accounting for confounding factors, however, pre-op AF was associated with a 63% increase in 30-day mortality [4.2% vs. 1.4%; hazard ratio (HR), 1.63; 95% confidence interval (CI), 1.17-2.29; p=0.004] and 39% increase in late mortality (5-year survival, 78% vs. 90%; HR, 1.39; 95% CI, 1.20-1.61; p<0.001).Pre-op AF is an independent predictor of poor early and late outcomes. Pre-op AF should be considered, therefore, in the development or update of risk stratification models for CABG surgery.
Internal ID Number: 24998984
URI: http://ahro.austin.org.au/austinjspui/handle/1/12295
DOI: 10.1016/j.jjcc.2014.06.003
URL: http://www.ncbi.nlm.nih.gov/pubmed/24998984
Type: Journal Article
Subjects: Atrial fibrillation
Cardiac surgery
Coronary artery bypass graft
Morbidity
Survival
Appears in Collections:Journal articles

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