PMID- 20667332
OWN - NLM
STAT- MEDLINE
DCOM- 20100824
LR  - 20220318
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 90
IP  - 2
DP  - 2010 Aug
TI  - New-onset postoperative atrial fibrillation and long-term survival after aortic 
      valve replacement surgery.
PG  - 474-9
LID - 10.1016/j.athoracsur.2010.02.081 [doi]
AB  - BACKGROUND: Atrial fibrillation (AF) is recognized as a common complication of 
      open cardiac surgery, occurring in up to 65% of patients. The advancing age and 
      increasing risk profile of patients receiving aortic valve replacement (AVR) 
      surgery is expected to raise incidence of new-onset postoperative AF resulting in 
      potentially higher risk of adverse outcomes. In the early postoperative course, 
      new-onset post-AVR AF is considered relatively easy to treat and is believed to 
      have little impact on patients' long-term outcome. However, the effect of 
      new-onset post-AVR AF on long-term survival is unclear. METHODS: Survival was 
      assessed in 1,039 consecutive patients without preoperative AF who underwent AVR 
      with or without simultaneous coronary artery bypass graft at Baylor University 
      Medical Center, Dallas, Texas between January 1, 1997 and December 31, 2006. 
      RESULTS: Ten-year unadjusted survival was 50.8% for patients with new-onset 
      postoperative AF and 59.4% for patients without. A propensity-adjusted model 
      controlling for risk factors identified by the Society of Thoracic Surgeons and 
      other clinical-nonclinical details was used to investigate the association 
      between new-onset AF post-AVR and survival. After adjustment, new-onset AF 
      post-AVR was significantly associated with increased risk of death (hazard ratio: 
      1.48; 95% confidence interval 1.12 to 1.96). CONCLUSIONS: This study provides 
      evidence that new-onset post-AVR AF is significantly associated with increased 
      long-term risk of mortality independent of the preoperative severity of disease. 
      After controlling for a comprehensive array of risk factors associated with 
      post-AVR adverse outcomes, risk of long-term mortality in patients who developed 
      new-onset post-AVR AF was 48% higher than in patients without it.
CI  - Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Filardo, Giovanni
AU  - Filardo G
AD  - Institute for Health Care Research and Improvement, Baylor Research Institute, 
      Dallas, TX 76206, USA. giovanfi@baylorhealth.edu
FAU - Hamilton, Cody
AU  - Hamilton C
FAU - Hamman, Baron
AU  - Hamman B
FAU - Hebeler, Robert F Jr
AU  - Hebeler RF Jr
FAU - Adams, John
AU  - Adams J
FAU - Grayburn, Paul
AU  - Grayburn P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 2010 Aug;90(2):479-80. PMID: 20667333
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve
MH  - Atrial Fibrillation/*etiology/*mortality
MH  - Coronary Artery Bypass/*adverse effects/*mortality
MH  - Female
MH  - Heart Valve Prosthesis Implantation/*adverse effects/*mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Survival Rate
MH  - Time Factors
EDAT- 2010/07/30 06:00
MHDA- 2010/08/25 06:00
CRDT- 2010/07/30 06:00
PHST- 2009/12/29 00:00 [received]
PHST- 2010/02/23 00:00 [revised]
PHST- 2010/02/26 00:00 [accepted]
PHST- 2010/07/30 06:00 [entrez]
PHST- 2010/07/30 06:00 [pubmed]
PHST- 2010/08/25 06:00 [medline]
AID - S0003-4975(10)00494-7 [pii]
AID - 10.1016/j.athoracsur.2010.02.081 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2010 Aug;90(2):474-9. doi: 10.1016/j.athoracsur.2010.02.081.