The Canadian journal of cardiology · 2026
Association of Atrial Fibrillation Status With Risk of Strokes, Mortality, and Cardiovascular Outcomes in Patients Undergoing Coronary Artery Bypass Grafting.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Yan Aimy, Ravindran Jayant, Chow Vincent, Brieger David, Kritharides Leonard, Chwan Ng Austin Chin
Аннотация
BACKGROUND: Postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG). Comparative outcome studies among patients following CABG with POAF pre-existing/background atrial fibrillation (AF), and no AF are scarce.
METHODS: Patients undergoing CABG between January 1, 2004 and December 31, 2017 were identified from a statewide Admitted Patient Data Collection database. Patients < 18 years of age or with concomitant cardiac valve surgery were excluded. Patients were stratified into no AF, background AF, and POAF during index CABG using a lookback linkage methodology. Primary outcome was incidence of ischemic stroke/transient ischemic attack (TIA) requiring hospitalization. Secondary outcomes included all-cause mortality and hospitalization with AF, heart failure (HF), hemorrhagic stroke. Competing risk and Cox regression methods were used to assess risk for cardiovascular endpoints and death, respectively.
RESULTS: Among 46,032 patients, 8.0% had background AF, 27.4% developed new-onset POAF during index CABG, and 64.7% had no AF. During follow-up (median 6.6 years), POAF was associated with increased risk of hospitalization for ischemic stroke/TIA compared with no AF cohort (adjusted subdistribution hazard ratio [adj.sHR], 1.14, 95% confidence interval [CI], 1.04-1.24; P = 0.004). The risk appears greater in patients with background AF (adj.sHR, 1.41, 95% CI, 1.25-1.60; P < 0.001). A graded association was observed across AF groups with highest morbidities (AF and HF hospitalizations) and mortality risks post-CABG in patients with background AF, followed by those with POAF, with no AF cohort having lowest event rates.
CONCLUSIONS: This large retrospective observational study suggests AF status during CABG surgery is associated with a graded increased risk of hospitalization for ischemic stroke/TIA, AF, HF, and death. These findings highlight an underrecognized high-risk population and underscore need for renewed clinical focus on patients with pre-existing AF undergoing CABG.
METHODS: Patients undergoing CABG between January 1, 2004 and December 31, 2017 were identified from a statewide Admitted Patient Data Collection database. Patients < 18 years of age or with concomitant cardiac valve surgery were excluded. Patients were stratified into no AF, background AF, and POAF during index CABG using a lookback linkage methodology. Primary outcome was incidence of ischemic stroke/transient ischemic attack (TIA) requiring hospitalization. Secondary outcomes included all-cause mortality and hospitalization with AF, heart failure (HF), hemorrhagic stroke. Competing risk and Cox regression methods were used to assess risk for cardiovascular endpoints and death, respectively.
RESULTS: Among 46,032 patients, 8.0% had background AF, 27.4% developed new-onset POAF during index CABG, and 64.7% had no AF. During follow-up (median 6.6 years), POAF was associated with increased risk of hospitalization for ischemic stroke/TIA compared with no AF cohort (adjusted subdistribution hazard ratio [adj.sHR], 1.14, 95% confidence interval [CI], 1.04-1.24; P = 0.004). The risk appears greater in patients with background AF (adj.sHR, 1.41, 95% CI, 1.25-1.60; P < 0.001). A graded association was observed across AF groups with highest morbidities (AF and HF hospitalizations) and mortality risks post-CABG in patients with background AF, followed by those with POAF, with no AF cohort having lowest event rates.
CONCLUSIONS: This large retrospective observational study suggests AF status during CABG surgery is associated with a graded increased risk of hospitalization for ischemic stroke/TIA, AF, HF, and death. These findings highlight an underrecognized high-risk population and underscore need for renewed clinical focus on patients with pre-existing AF undergoing CABG.