PMID- 24796333
OWN - NLM
STAT- MEDLINE
DCOM- 20150330
LR  - 20221207
IS  - 1569-9285 (Electronic)
IS  - 1569-9285 (Linking)
VI  - 19
IP  - 2
DP  - 2014 Aug
TI  - Preoperative atrial fibrillation predicts mortality and morbidity after aortic 
      valve replacement.
PG  - 218-22
LID - 10.1093/icvts/ivu128 [doi]
AB  - OBJECTIVES: Atrial fibrillation (AF) is the commonest cardiac arrhythmia, 
      becoming increasingly prevalent as the population ages. There is conflicting 
      information around whether AF is associated with adverse outcomes after aortic 
      valve replacement (AVR) from the few studies that have investigated this. We 
      compared the characteristics and outcomes of patients undergoing AVR with their 
      history of AF. METHODS: Isolated AVR patients at Auckland City Hospital 2005-2012 
      were divided into those with and without preoperative AF for comparative 
      analyses. RESULTS: Of 620 consecutive patients, 19.2% (119) had permanent or 
      paroxysmal AF preoperatively. Patients with AF were significantly older (70.5 vs 
      63.4 years, P < 0.001) and were more likely to be New Zealand European (82.4 vs 
      68.1%, P = 0.004). They also had higher prevalence of NYHA class III-IV (55.4 vs 
      37.4%, P = 0.004), inpatient operation (62.1 vs 48.3%, P = 0.008), history of 
      stroke (10.9 vs 5.0%, P = 0.031), lower creatinine clearance (73 vs 82, P = 
      0.001) and higher EuroSCORE II (5.2 vs 3.4%, P < 0.001). Operative mortality (6.7 
      vs 2.0%, P = 0.012) and composite morbidity (27.7 vs 16.5%, P = 0.006) were also 
      higher in patients with AF. After adjusting for significant variables, 
      preoperative AF remained an independent predictor of operative mortality with an 
      odds ratio of 3.44 (95% confidence interval 1.29-9.13), composite morbidity of 
      1.79 (1.05-3.04) and a mortality during follow-up hazards ratio of 2.36 
      (1.44-3.87). CONCLUSIONS: AF was associated with several cardiovascular and 
      cardiac surgery risk factors, but remained independently associated with short- 
      and long-term mortality. AF should be incorporated into cardiac surgery risk 
      models and surgical AF ablation may be considered with AVR.
CI  - (c) The Author 2014. Published by Oxford University Press on behalf of the European 
      Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Wang, Tom Kai Ming
AU  - Wang TK
AD  - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand 
      twang@adhb.govt.nz.
FAU - Ramanathan, Tharumenthiran
AU  - Ramanathan T
AD  - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
FAU - Choi, David Hyun-Min
AU  - Choi DH
AD  - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
FAU - Gamble, Greg
AU  - Gamble G
AD  - Department of Medicine, University of Auckland, Auckland, New Zealand.
FAU - Ruygrok, Peter
AU  - Ruygrok P
AD  - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand 
      Department of Medicine, University of Auckland, Auckland, New Zealand.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20140505
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/diagnosis/ethnology/mortality/*surgery
MH  - Atrial Fibrillation/diagnosis/ethnology/*mortality
MH  - Comorbidity
MH  - Female
MH  - Heart Valve Prosthesis Implantation/*adverse effects/*mortality
MH  - Hospitals, Urban
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - New Zealand/epidemiology
MH  - Odds Ratio
MH  - Prevalence
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - White People
OTO - NOTNLM
OT  - Aortic stenosis
OT  - Aortic valve replacement
OT  - Arrhythmia
OT  - Atrial fibrillation
OT  - Cardiac surgery
EDAT- 2014/05/07 06:00
MHDA- 2015/03/31 06:00
CRDT- 2014/05/07 06:00
PHST- 2014/05/07 06:00 [entrez]
PHST- 2014/05/07 06:00 [pubmed]
PHST- 2015/03/31 06:00 [medline]
AID - ivu128 [pii]
AID - 10.1093/icvts/ivu128 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2014 Aug;19(2):218-22. doi: 
      10.1093/icvts/ivu128. Epub 2014 May 5.