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Cited by 715Atrial Fibrillation Management and OutcomesCardiac and Coronary Surgery TechniquesCardiac, Anesthesia and Surgical Outcomes

The DOI matches its Crossref record; 23 of the 24 references it cites were found in a registry or an index.

Postoperative atrial fibrillation and mortality after coronary artery bypass surgery

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Villareal, Rollo P., Hariharan, Ramesh, Liu, Brant C., Kar, Biswajit, Lee, Vei-Vei, Elayda, MacArthur, Lopez, J.Alberto, Rasekh, Abdi, Wilson, James M., Massumi, Ali·2004·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2003.11.023
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Abstract

Objectives We sought to determine if the occurrence of postoperative atrial fibrillation (AF) affects early or late mortality following coronary artery bypass surgery (CABG).Background Atrial fibrillation is the most common arrhythmia seen following CABG.Methods The Texas Heart Institute Cardiovascular Research Database was used to identify all patients that developed AF after isolated initial CABG from January 1993 to December 1999 (n = 994). This population was compared with patients who underwent CABG during the same period but did not develop AF (n = 5,481). In-hospital end points were adjusted using logistic regression models to account for baseline differences. Long-term survival was evaluated using a retrospective cohort design, where Cox proportional hazards methods were used to adjust for baseline differences, and with case-matched populations (n = 390, 195 per arm).Results Atrial fibrillation was diagnosed in 16% of the population. Postoperative AF was associated with greater in-hospital mortality (odds ratio [OR] 1.7, p = 0.0001), more strokes (OR 2.02, p = 0.001), prolonged hospital stays (14 vs. 10 days, p < 0.0001), and a reduced incidence of myocardial infarction (OR 0.62, p = 0.01). At four to five years, survival was worse in patients who developed postoperative AF (74% vs. 87%, p < 0.0001 in the retrospective cohort; 80% vs. 93%, p = 0.003 in the case-matched population). On multivariate analysis, postoperative AF was an independent predictor of long-term mortality (adjusted OR 1.5, p < 0.001 in the retrospective cohort; OR 3.4, p = 0.0018 in the case-matched population).Conclusions The occurrence of AF following CABG identifies a subset of patients who have a reduced survival probability following CABG. The impact of various strategies, such as antiarrhythmics and warfarin, aimed at reducing AF and its complications deserves further study.

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Authors
Villareal, R. P., Hariharan, R., Liu, B. C., Kar, B., Lee, V.-V., Elayda, M., Lopez, J. A., Rasekh, A., Wilson, J. M., & Massumi, A.
Affiliations
  • Self Regional Healthcare (US)
  • Baylor St. Luke's Medical Center (US)
Corresponding author
Villareal, Rollo P.
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2004-03
Volume
43
Issue
5
Pages
742-748
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2003.11.023
OpenAlex
W2109784377
Cited by
715
References
24
Citations by year
2026: 21 · 2025: 21 · 2024: 56 · 2023: 22 · 2022: 32 · 2021: 55 · 2020: 35 · 2019: 36 · 2018: 33 · 2017: 41 · 2016: 35 · 2015: 40 · 2014: 39 · 2013: 39 · 2012: 39
FWCI
13.29
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Keywords
postoperative atrial fibrillation, coronary artery bypass grafting, mortality, long-term survival, stroke, length of hospital stay, myocardial infarction, antiarrhythmic therapy, warfarin
MeSH terms
Aged, Coronary Artery Bypass, Atrial Fibrillation, Cardiac Care Facilities, Female, Humans, Length of Stay, Male, Middle Aged, Myocardial Infarction, Retrospective Studies, Texas, Time Factors, Cohort Studies, Proportional Hazards Models, Survival Analysis, Hospital Mortality, Databases as Topic, Stroke

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