PMID- 34309884
OWN - NLM
STAT- MEDLINE
DCOM- 20210913
LR  - 20220607
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 36
IP  - 10
DP  - 2021 Oct
TI  - Preoperative Atrial Fibrillation is associated with long-term morTality in 
      patients undergoing suRgical AortiC valvE Replacement.
PG  - 3561-3566
LID - 10.1111/jocs.15844 [doi]
AB  - INTRODUCTION: Atrial fibrillation (AF) is frequent after any cardiac surgery, but 
      evidence suggests it may have no significant impact on survival if sinus rhythm 
      (SR) is effectively restored early after the onset of the arrhythmia. In 
      contrast, management of preoperative AF is often overlooked during or after 
      cardiac surgery despite several proposed protocols. This study sought to evaluate 
      the impact of preoperative AF on mortality in patients undergoing isolated 
      surgical aortic valve replacement (AVR). METHODS: We performed a retrospective, 
      single-center study involving 2628 consecutive patients undergoing elective, 
      primary isolated surgical AVR from 2008 to 2018. A total of 268/2628 patients 
      (10.1%) exhibited AF before surgery. The effect of preoperative AF on mortality 
      was evaluated with univariate and multivariate analyses. RESULTS: Short-term 
      mortality was 0.8% and was not different between preoperative AF and SR cohorts. 
      Preoperative AF was highly predictive of long-term mortality (median follow-up of 
      4 years [Q1-Q3 2-7]; hazard ratio [HR]: 2.24, 95% confidence interval [CI]: 
      1.79-2.79, p < .001), and remained strongly and independently predictive after 
      adjustment for other risk factors (HR: 1.54, 95% CI: 1.21-1.96, p < .001) 
      compared with preoperative SR. In propensity score-matched analysis, the adjusted 
      mortality risk was higher in the AF cohort (OR: 1.47, 95% CI: 1.04-1.99, p = .03) 
      compared with the SR cohort. CONCLUSIONS: Preoperative AF was independently 
      predictive of long-term mortality in patients undergoing isolated surgical AVR. 
      It remains to be seen whether concomitant surgery or other preoperative measures 
      to correct AF may impact long-term survival.
CI  - (c) 2021 Wiley Periodicals LLC.
FAU - Farag, Mohamed
AU  - Farag M
AUID- ORCID: 0000-0003-0811-7679
AD  - Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
AD  - Postgraduate Medical School, University of Hertfordshire, Hertfordshire, UK.
FAU - Kiberu, Yusuf
AU  - Kiberu Y
AD  - Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
FAU - Ashwin Reddy, S
AU  - Ashwin Reddy S
AD  - Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
FAU - Shoaib, Ahmad
AU  - Shoaib A
AD  - Keele University, Stoke-on-Trent, UK.
FAU - Egred, Mohaned
AU  - Egred M
AUID- ORCID: 0000-0003-3642-318X
AD  - Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
FAU - Krishnan, Unni
AU  - Krishnan U
AD  - Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
FAU - Fares, Mina
AU  - Fares M
AD  - Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
FAU - Peverelli, Marta
AU  - Peverelli M
AD  - Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
FAU - Gorog, Diana A
AU  - Gorog DA
AUID- ORCID: 0000-0002-9286-1451
AD  - Postgraduate Medical School, University of Hertfordshire, Hertfordshire, UK.
FAU - Elmahdy, Walid
AU  - Elmahdy W
AD  - Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
FAU - Berman, Marius
AU  - Berman M
AUID- ORCID: 0000-0002-9144-5376
AD  - Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
FAU - Osman, Mohamed
AU  - Osman M
AUID- ORCID: 0000-0003-0439-4951
AD  - Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
AD  - National Heart Institute, Giza, Egypt.
CN  - AF-TRACER investigators
LA  - eng
PT  - Journal Article
DEP - 20210726
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
CIN - J Card Surg. 2022 Jul;37(7):2230-2231. PMID: 35243689
MH  - Aortic Valve/surgery
MH  - *Atrial Fibrillation/complications/surgery
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - aortic valve replacement
OT  - atrial fibrillation
OT  - mortality
EDAT- 2021/07/27 06:00
MHDA- 2021/09/14 06:00
CRDT- 2021/07/26 12:37
PHST- 2021/01/24 00:00 [received]
PHST- 2021/05/23 00:00 [accepted]
PHST- 2021/07/27 06:00 [pubmed]
PHST- 2021/09/14 06:00 [medline]
PHST- 2021/07/26 12:37 [entrez]
AID - 10.1111/jocs.15844 [doi]
PST - ppublish
SO  - J Card Surg. 2021 Oct;36(10):3561-3566. doi: 10.1111/jocs.15844. Epub 2021 Jul 
      26.