PMID- 36036747
OWN - NLM
STAT- MEDLINE
DCOM- 20221206
LR  - 20230302
IS  - 1897-4279 (Electronic)
IS  - 0022-9032 (Linking)
VI  - 80
IP  - 11
DP  - 2022
TI  - Total arterial revascularization coronary artery bypass surgery in patients with 
      atrial fibrillation.
PG  - 1119-1126
LID - 10.33963/KP.a2022.0200 [doi]
AB  - BACKGROUND: Atrial fibrillation (AF) is a relatively common comorbidity among 
      patients referred for coronary artery bypass grafting (CABG) and is associated 
      with poorer prognosis. However, little is known about how surgical technique 
      influences survival in this population. AIM: The current analysis aimed to 
      determine whether total arterial revascularization (TAR) is associated with 
      improved long-term outcomes in patients with preoperative AF. METHODS: We 
      analyzed patients' data from the HEIST (HEart surgery In atrial fibrillation and 
      Supraventricular Tachycardia) registry. The registry, to date, involves five 
      tertiary high-volume centers in Poland. Between 2006 and 2019, 4746 patients 
      presented with preoperative AF and multivessel coronary artery disease and 
      underwent CABG. We identified cases of TAR and used propensity score matching to 
      determine non-TAR controls. Median follow-up was 4.1 years (interquartile range 
      [IQR], 1.9-6.8 years). RESULTS: Propensity matching resulted in 295 pairs of TAR 
      vs. non-TAR. The mean (standard deviation [SD]) number of distal anastomoses was 
      2.5 (0.6) vs. 2.5 (0.6) (P = 0.94) respectively. Operative and 30-day mortality 
      was not different between TAR and non-TAR patients (hazard ratio [HR] and 95% 
      confidence intervals [CIs], 0.17 (0.02-1.38); P = 0.12 and 0.74 [0.40-1.35]; P = 
      0.33, respectively). By contrast, TAR was associated with nearly 30% improved 
      late survival: HR, 0.72 (0.55-0.93); P = 0.01. This benefit was sustained in 
      subgroup analyses, yet most pronounced in low-risk patients ( < 70 years old; 
      EuroSCORE II < 2; no diabetes) and when off-pump CABG was performed. CONCLUSIONS: 
      TAR in patients with preoperative AF is safe and associated with improved 
      survival, with particular survival benefits in younger low-risk patients 
      undergoing off-pump CABG.
FAU - Pasierski, Michal
AU  - Pasierski M
AD  - Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of 
      Interior, Center of Postgraduate Medical Education, Warszawa, Poland.
FAU - Czarnecka, Karolina
AU  - Czarnecka K
AD  - Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of 
      Interior, Center of Postgraduate Medical Education, Warszawa, Poland.
FAU - Staromlynski, Jakub
AU  - Staromlynski J
AD  - Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of 
      Interior, Center of Postgraduate Medical Education, Warszawa, Poland.
FAU - Litwinowicz, Radoslaw
AU  - Litwinowicz R
AD  - Department of Cardiovascular Surgery and Transplantology, Jagiellonian University 
      Medical College, John Paul II Hospital, Krakow, Poland.
FAU - Filip, Grzegorz
AU  - Filip G
AD  - Department of Cardiovascular Surgery and Transplantology, Jagiellonian University 
      Medical College, John Paul II Hospital, Krakow, Poland.
FAU - Kowalowka, Adam
AU  - Kowalowka A
AD  - Department of Cardiac Surgery, Medical University of Silesia, School of Medicine 
      in Katowice, Katowice, Poland.
AD  - Department of Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland.
FAU - Wanha, Wojciech
AU  - Wanha W
AD  - Department of Cardiology and Structural Heart Diseases, Medical University of 
      Silesia, Katowice, Poland.
FAU - Kolodziejczak, Michalina
AU  - Kolodziejczak M
AD  - Department of Anesthesiology and Intensive Care, Collegium Medicum Nicolaus 
      Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, 
      Poland.
AD  - Division of Cardiology, Yale School of Medicine, New Haven, Connecticut, USA.
FAU - Piekus-Slomka, Natalia
AU  - Piekus-Slomka N
AD  - Department of Inorganic and Analytical Chemistry, Nicolaus Copernicus University 
      in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Poland.
FAU - Los, Andrzej
AU  - Los A
AD  - Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, 
      Poland.
FAU - Stefaniak, Sebastian
AU  - Stefaniak S
AD  - Department of Cardiac Surgery and Transplantology, Poznan University of Medical 
      Sciences, Poznan, Poland.
FAU - Wojakowski, Wojciech
AU  - Wojakowski W
AD  - Department of Cardiology and Structural Heart Diseases, Medical University of 
      Silesia, Katowice, Poland.
FAU - Jemielity, Marek
AU  - Jemielity M
AD  - Department of Cardiac Surgery and Transplantology, Poznan University of Medical 
      Sciences, Poznan, Poland.
FAU - Rogowski, Jan
AU  - Rogowski J
AD  - Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, 
      Poland.
FAU - Deja, Marek
AU  - Deja M
AD  - Department of Cardiac Surgery, Medical University of Silesia, School of Medicine 
      in Katowice, Katowice, Poland.
AD  - Department of Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland.
FAU - Jagielak, Dariusz
AU  - Jagielak D
AD  - Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, 
      Poland.
FAU - Bartus, Krzysztof
AU  - Bartus K
AD  - Department of Cardiovascular Surgery and Transplantology, Jagiellonian University 
      Medical College, John Paul II Hospital, Krakow, Poland.
FAU - Mariani, Silvia
AU  - Mariani S
AD  - Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht 
      University Medical Center, Maastricht, the Netherlands.
FAU - Li, Tong
AU  - Li T
AD  - Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover 
      Medical School, Hannover, Germany.
FAU - Lorusso, Roberto
AU  - Lorusso R
AD  - Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht 
      University Medical Center, Maastricht, the Netherlands.
FAU - Suwalski, Piotr
AU  - Suwalski P
AD  - Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of 
      Interior, Center of Postgraduate Medical Education, Warszawa, Poland.
FAU - Kowalewski, Mariusz
AU  - Kowalewski M
AD  - Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of 
      Interior, Center of Postgraduate Medical Education, Warszawa, Poland. 
      kowalewskimariusz@gazeta.pl.
AD  - Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht 
      University Medical Center, Maastricht, the Netherlands. 
      kowalewskimariusz@gazeta.pl.
AD  - Thoracic Research Center, Collegium Medicum Nicolaus Copernicus University, 
      Innovative Medical Forum, Bydgoszcz, Poland. kowalewskimariusz@gazeta.pl.
LA  - eng
PT  - Journal Article
DEP - 20220829
PL  - Poland
TA  - Kardiol Pol
JT  - Kardiologia polska
JID - 0376352
SB  - IM
MH  - Humans
MH  - Aged
MH  - *Atrial Fibrillation/complications
MH  - Retrospective Studies
MH  - Coronary Artery Bypass
MH  - *Coronary Artery Bypass, Off-Pump/adverse effects
MH  - *Coronary Artery Disease/complications/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - CABG
OT  - arterial grafts
OT  - atrial fibrillation
OT  - survival
OT  - total arterial revascularization
EDAT- 2022/08/30 06:00
MHDA- 2022/12/07 06:00
CRDT- 2022/08/29 10:42
PHST- 2022/08/01 00:00 [received]
PHST- 2022/08/01 00:00 [accepted]
PHST- 2022/08/30 06:00 [pubmed]
PHST- 2022/12/07 06:00 [medline]
PHST- 2022/08/29 10:42 [entrez]
AID - VM/OJS/J/91212 [pii]
AID - 10.33963/KP.a2022.0200 [doi]
PST - ppublish
SO  - Kardiol Pol. 2022;80(11):1119-1126. doi: 10.33963/KP.a2022.0200. Epub 2022 Aug 
      29.