TY - JOUR
T1 - Prospective Study of Risk Factors for Postoperative Atrial Fibrillation After Cardiac Surgery
AU - Cardiothoracic Surgical Trials Network
AU - Bowdish, Michael E.
AU - Bagiella, Emilia
AU - Giustino, Gennaro
AU - Atluri, Pavan
AU - Alexander, John H.
AU - Thourani, Vinod H.
AU - Gammie, James S.
AU - DeRose, Joseph J.
AU - Taddei-Peters, Wendy C.
AU - Jeffries, Neal O.
AU - O'Gara, Patrick T.
AU - Moskowitz, Alan J.
AU - Gillinov, Marc
AU - Gelijns, Annetine C.
AU - Ailawadi, Gorav
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2024/2
Y1 - 2024/2
N2 - Introduction: To examine risk factors for new-onset postoperative atrial fibrillation (POAF) after cardiac surgery. Methods: Patients enrolled in the Cardiothoracic Surgical Trials Network multicenter, randomized trial of rate control versus rhythm control for POAF were included. Predictors of POAF were determined using multivariable logistic regression. Results: Among the 2104 patients who were enrolled preoperatively, 695 developed POAF (33.0%). Rates of POAF were 28.1% after isolated coronary artery bypass grafting (CABG), 33.7% after isolated valve repair or replacement, and 47.3% after CABG plus valve repair or replacement. Baseline characteristics associated with an increased risk of POAF identified on multivariable analysis included older age (odds ratio [OR] 1.57; 95% confidence interval [CI] 1.42-1.73, per 10 y), White race or non-Hispanic ethnicity (OR 1.52; CI: 1.11-2.07), history of heart failure (OR 1.55; CI: 1.16-2.08), and history of hypothyroidism (OR 1.42; CI 1.04-1.94). The type of cardiac procedure was associated with an increased risk of POAF with both isolated valve repair or replacement (OR 1.33, CI 1.08-1.64) and combined CABG plus valve repair or replacement (OR 1.64, CI 1.24-2.17) having increased risk of POAF compared to isolated CABG. No preoperative cardiac medication was associated with POAF. Conclusions: In this prospective cohort of patients, older age, a history of hypothyroidism, a history of heart failure, and valve repair or replacement, with or without CABG, and White non-Hispanic race were associated with an increased risk of POAF.
AB - Introduction: To examine risk factors for new-onset postoperative atrial fibrillation (POAF) after cardiac surgery. Methods: Patients enrolled in the Cardiothoracic Surgical Trials Network multicenter, randomized trial of rate control versus rhythm control for POAF were included. Predictors of POAF were determined using multivariable logistic regression. Results: Among the 2104 patients who were enrolled preoperatively, 695 developed POAF (33.0%). Rates of POAF were 28.1% after isolated coronary artery bypass grafting (CABG), 33.7% after isolated valve repair or replacement, and 47.3% after CABG plus valve repair or replacement. Baseline characteristics associated with an increased risk of POAF identified on multivariable analysis included older age (odds ratio [OR] 1.57; 95% confidence interval [CI] 1.42-1.73, per 10 y), White race or non-Hispanic ethnicity (OR 1.52; CI: 1.11-2.07), history of heart failure (OR 1.55; CI: 1.16-2.08), and history of hypothyroidism (OR 1.42; CI 1.04-1.94). The type of cardiac procedure was associated with an increased risk of POAF with both isolated valve repair or replacement (OR 1.33, CI 1.08-1.64) and combined CABG plus valve repair or replacement (OR 1.64, CI 1.24-2.17) having increased risk of POAF compared to isolated CABG. No preoperative cardiac medication was associated with POAF. Conclusions: In this prospective cohort of patients, older age, a history of hypothyroidism, a history of heart failure, and valve repair or replacement, with or without CABG, and White non-Hispanic race were associated with an increased risk of POAF.
KW - Postoperative atrial fibrillation
KW - Risk factor
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U2 - 10.1016/j.jss.2023.09.060
DO - 10.1016/j.jss.2023.09.060
M3 - Article
C2 - 37931426
AN - SCOPUS:85175565269
SN - 0022-4804
VL - 294
SP - 262
EP - 268
JO - Journal of Surgical Research
JF - Journal of Surgical Research
ER -