The impact of post-operative atrial fibrillation on outcomes in coronary artery bypass graft and combined procedures

Yau Lam Alex Chau, Ji Won Yoo, Ho Chuen Yuen, Khalid Bin Waleed, Dong Chang, Tong Liu, Fang Zhou Liu, Gary Tse, Sharen Lee, Ka Hou Christien Li

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)

Abstract

BACKGROUND Post-operative atrial fibrillation (POAF) is a common yet understudied clinical issue after coronary artery bypass graft (CABG) leading to higher mortality rates and stroke. This systematic review and meta-analysis evaluated the rates of adverse outcomes between patients with and without POAF in patients treated with CABG or combined procedures. METHODS The search period was from the beginning of PubMed and Embase to May 18th, 2020 with no language restrictions. The inclusion criteria were: (1) studies comparing new onset atrial fibrillation before or after revascularization vs. no new onset AF before or after revascularization. The outcomes assessed included all-cause mortality, cardiac death, cerebral vascular accident (CVA), myocardial infarction (MI), repeated revascularization, major adverse cardiac event (MACE), and major adverse cardiac and cerebrovascular events (MACCEs). RESULTS Of the 7,279 entries screened, 11 studies comprising of 57,384 patients were included. Compared to non-POAF, POAF was significantly associated with higher risk of all-cause mortality (Risk Ratio (RR) = 1.58; 95% Confidence Interval (CI): 1.42−1.76, P < 0.00001) with accompanying high level of heterogeneity (I2 = 62%). Conclusions Patients with POAF after CABG or combined procedures are at an increased risk of all-cause mortality or CVAs. Therefore, POAF after such procedures should be closely monitored and treated judiciously to minimize risk of further complications. While there are studies on POAF versus no POAF on outcomes, the heterogeneity suggests that further studies are needed.

Original languageEnglish
Pages (from-to)319-326
Number of pages8
JournalJournal of Geriatric Cardiology
Volume18
Issue number5
DOIs
Publication statusPublished - May 2021
Externally publishedYes

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