Incidence of atrial fibrillation after coronary artery bypass graft surgery and risk factors affecting

Introduction: Postoperative onset atrial fibrillation (POAF) is a common complication of coronary artery bypass surgery (CABG). However, the long-term risk of thromboembolism in patients who develop POAF after CABG surgery is unknown. Also, there is no information about stroke prevention in this setting. To investigate the long-term risk of stroke and thromboembolism in patients with new-onset POAF after initial CABG alone compared with patients with non-functional non-valvular atrial fibrillation (NVAF)Material and Methods: This study used data from the Clinical Cardiac Surgery Database and the Danish National Registry to identify patients undergoing a primary CABG procedure and de novo CABG between January ۱, ۲۰۰۰ and June ۳۰, ۲۰۱۵. The age, sex, CHA۲DS۲-VASc score and year of diagnosis of these patients were compared with dysfunctional NVAF between ۱ and ۴. Data analysis was performed between ۲۰۱۲-۱۵. Proportion of patients starting oral anticoagulation within ۳۰ days and thromboembolic rate.Results: ۱۱۵ patients who developed POAF after CABG surgery and ۱۱۵ patients who developed NVAF were compared. In the total population of ۱۰,۵۴۰ patients, the median (interquartile range) age was ۶۹ years.۲ (۶۳.۷-۷۴.۷) years; ۸۶۷۵ patients (۸۲.۳%) were male. ۱۷۵ POAF patients (۸.۴% and ۳۵۴۹ patients with NVAF (۴۲.۹%). The risk of thromboembolism was lower in the POAF group than in the NVAF group (۱۸.۳ vs. ۲۹.۷ events per ۱۰۰۰ person-years; adjusted hazard ratio [HR], ۰.۵۵; ۹۵% confidence interval, ۰.۳۲-۰.۹۵; P = .۰۳) and NVAF (adjusted HR, ۰.۵۹; ۹۵% CI, ۰.۶۸; P < .۰۰۱) compared with patients not receiving anticoagulant therapy.Conclusion: Patients undergoing CABG surgery had a longer risk of thromboembolic new POAF than those undergoing NVAF. These data do not support the view that de novo POAF should be considered the same as primary NVAF in terms of long-term thromboembolic risk.

Keywords:

AF , CABG , ICU , Incidence