Cited by 143Atrial Fibrillation Management and OutcomesCardiac and Coronary Surgery TechniquesCardiac, Anesthesia and Surgical Outcomes

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New-onset atrial fibrillation following coronary bypass surgery predicts long-term mortality: a systematic review and meta-analysis

Phan, Kevin, Ha, Hakeem S.K., Phan, Steven, Medi, Caroline, Thomas, Stuart P., Yan, Tristan D.·2015·European Journal of Cardio-Thoracic Surgery

DOI 10.1093/ejcts/ezu551

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Abstract

Atrial fibrillation (AF) is one of the most common postoperative complications following cardiac surgery. Recent evidence suggests that postoperative atrial fibrillation (POAF) may be more 'malignant' than previously thought, associated with follow-up mortality and morbidity. To evaluate the long-term survival of POAF versus No-POAF cohorts following coronary bypass surgery, the current meta-analysis with reconstructed individual patient data was performed. Electronic searches were performed using six databases from their inception to August 2014. Relevant studies with long-term survival data presented for POAF versus No-POAF were identified. Data were extracted by two independent reviewers and analysed according to predefined clinical endpoints. The pooled hazard ratio (HR) significantly favoured higher survival in No-POAF over POAF (HR 1.28; 95% CI, 1.19-1.37; I(2) = 96%; P < 0.00001). Individual patient data of 69 518 patients were available for inverted Kaplan-Meier survival curve analysis. Analysis of aggregate data using Kaplan-Meier curve methods for POAF versus No-POAF groups determined survival rates at the 1-year (95.7 vs 98%), 2-year (92.3 vs 95.4%), 3-year (88.7 vs 93.9%), 5-year (82.6 vs 89.4%) and 10-year (65.5 vs 75.3%) follow-up. Other complications including 30-day mortality, strokes, respiratory failure, pneumonia and hospitalization were significantly higher in the POAF group. New-onset AF following coronary bypass surgery is associated with significantly higher risk of mortality in short- and long-term follow-up. Current evidence suggests the need for stricter surveillance and monitoring of POAF following coronary bypass surgery.

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Authors: Phan, K., Ha, H. S. K., Phan, S., Medi, C., Thomas, S. P., & Yan, T. D.
Affiliations: Westmead Hospital (AU)
UNSW Sydney (AU)
Collaborative Research Group (AU)
The University of Sydney (AU)
Corresponding author: Yan, Tristan D.
ORCID: Phan, Kevin
Phan, Steven
Thomas, Stuart P.
Yan, Tristan D.
Venue: European Journal of Cardio-Thoracic Surgery
Publisher: Oxford University Press (OUP)
Published: 2015-01-18
Volume: 48
Issue: 6
Pages: 817-824
ISSN: 1010-7940 (ISSN-L)
1873-734X
DOI: 10.1093/ejcts/ezu551
OpenAlex: W2006452581
Cited by: 143
References: 43
Citations by year: 2026: 8 · 2025: 8 · 2024: 13 · 2023: 16 · 2022: 12 · 2021: 18 · 2020: 20 · 2019: 17 · 2018: 4 · 2017: 11 · 2016: 11 · 2015: 5
FWCI: 1.78
Type: journal article
Language: en
Open access: closed
Locations: European Journal of Cardio-Thoracic Surgery (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, long-term mortality, postoperative complications, cardiac surgery, stroke, respiratory failure, pneumonia, hospitalization, postoperative follow-up
MeSH terms: Coronary Artery Bypass, Atrial Fibrillation, Humans, Survival Analysis, Kaplan-Meier Estimate

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New-onset atrial fibrillation following coronary bypass surgery predicts long-term mortality: a systematic review and meta-analysis

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