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New‐onset atrial fibrillation and outcomes following isolated coronary artery bypass surgery: A systematic review and meta‐analysis

Prior meta‐analyses have shown that new‐onset atrial fibrillation (NOAF) occurs in up to 40% of patients following cardiac surgery and is associated with substantial major adverse cardiovascular events. The stroke and mortality implications of NOAF in isolated CABG without concomitant valve surgery...

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Autores principales: Kerwin, Matthew, Saado, Jonathan, Pan, Jonathan, Ailawadi, Gorav, Mazimba, Sula, Salerno, Michael, Mehta, Nishaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Periodicals, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462196/
https://www.ncbi.nlm.nih.gov/pubmed/32696468
http://dx.doi.org/10.1002/clc.23414
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author Kerwin, Matthew
Saado, Jonathan
Pan, Jonathan
Ailawadi, Gorav
Mazimba, Sula
Salerno, Michael
Mehta, Nishaki
author_facet Kerwin, Matthew
Saado, Jonathan
Pan, Jonathan
Ailawadi, Gorav
Mazimba, Sula
Salerno, Michael
Mehta, Nishaki
author_sort Kerwin, Matthew
collection PubMed
description Prior meta‐analyses have shown that new‐onset atrial fibrillation (NOAF) occurs in up to 40% of patients following cardiac surgery and is associated with substantial major adverse cardiovascular events. The stroke and mortality implications of NOAF in isolated CABG without concomitant valve surgery is not known. We thought that NOAF would be associated with increased risk of stroke and mortality, even in patients undergoing isolated CABG. A blinded review of studies from MEDLINE, CENTRAL, and Web of Science was done by two independent investigators. Stroke, 30‐day/hospital mortality, long‐term cardiovascular mortality, and long‐term (>1 year) all‐cause mortality were analyzed. We used Review Manager Version 5.3 to perform pooled analysis of outcomes. Of 4461 studies identified, 19 studies (n = 129 628) met inclusion criteria. NOAF incidence ranged from 15% to 36%. NOAF was associated with increased risk of stroke (unadjusted OR 2.15 [1.82, 2.53] [P < .00001]; adjusted OR 1.88 [1.02, 3.46] [P = .04]). NOAF was associated with increased 30‐day/hospital mortality (OR 2.35 [1.67, 3.32] [P < .00001]) and long‐term cardiovascular mortality (OR 2.04 [1.35, 3.09] [P = .0007]) NOAF was associated with increased long‐term all‐cause mortality (unadjusted OR 1.79 [1.63, 1.96] [P < .00001]; adjusted OR 1.58 [1.24, 2.00] [P = .0002]). We found that the incidence of NOAF following isolated CABG is high and is associated with increased stroke rate and mortality. Early recognition and management of NOAF could improve outcomes.
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spelling pubmed-74621962020-09-03 New‐onset atrial fibrillation and outcomes following isolated coronary artery bypass surgery: A systematic review and meta‐analysis Kerwin, Matthew Saado, Jonathan Pan, Jonathan Ailawadi, Gorav Mazimba, Sula Salerno, Michael Mehta, Nishaki Clin Cardiol Reviews Prior meta‐analyses have shown that new‐onset atrial fibrillation (NOAF) occurs in up to 40% of patients following cardiac surgery and is associated with substantial major adverse cardiovascular events. The stroke and mortality implications of NOAF in isolated CABG without concomitant valve surgery is not known. We thought that NOAF would be associated with increased risk of stroke and mortality, even in patients undergoing isolated CABG. A blinded review of studies from MEDLINE, CENTRAL, and Web of Science was done by two independent investigators. Stroke, 30‐day/hospital mortality, long‐term cardiovascular mortality, and long‐term (>1 year) all‐cause mortality were analyzed. We used Review Manager Version 5.3 to perform pooled analysis of outcomes. Of 4461 studies identified, 19 studies (n = 129 628) met inclusion criteria. NOAF incidence ranged from 15% to 36%. NOAF was associated with increased risk of stroke (unadjusted OR 2.15 [1.82, 2.53] [P < .00001]; adjusted OR 1.88 [1.02, 3.46] [P = .04]). NOAF was associated with increased 30‐day/hospital mortality (OR 2.35 [1.67, 3.32] [P < .00001]) and long‐term cardiovascular mortality (OR 2.04 [1.35, 3.09] [P = .0007]) NOAF was associated with increased long‐term all‐cause mortality (unadjusted OR 1.79 [1.63, 1.96] [P < .00001]; adjusted OR 1.58 [1.24, 2.00] [P = .0002]). We found that the incidence of NOAF following isolated CABG is high and is associated with increased stroke rate and mortality. Early recognition and management of NOAF could improve outcomes. Wiley Periodicals, Inc. 2020-07-21 /pmc/articles/PMC7462196/ /pubmed/32696468 http://dx.doi.org/10.1002/clc.23414 Text en © 2020 The Authors. Clinical Cardiology published by Wiley Periodicals LLC. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Reviews
Kerwin, Matthew
Saado, Jonathan
Pan, Jonathan
Ailawadi, Gorav
Mazimba, Sula
Salerno, Michael
Mehta, Nishaki
New‐onset atrial fibrillation and outcomes following isolated coronary artery bypass surgery: A systematic review and meta‐analysis
title New‐onset atrial fibrillation and outcomes following isolated coronary artery bypass surgery: A systematic review and meta‐analysis
title_full New‐onset atrial fibrillation and outcomes following isolated coronary artery bypass surgery: A systematic review and meta‐analysis
title_fullStr New‐onset atrial fibrillation and outcomes following isolated coronary artery bypass surgery: A systematic review and meta‐analysis
title_full_unstemmed New‐onset atrial fibrillation and outcomes following isolated coronary artery bypass surgery: A systematic review and meta‐analysis
title_short New‐onset atrial fibrillation and outcomes following isolated coronary artery bypass surgery: A systematic review and meta‐analysis
title_sort new‐onset atrial fibrillation and outcomes following isolated coronary artery bypass surgery: a systematic review and meta‐analysis
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462196/
https://www.ncbi.nlm.nih.gov/pubmed/32696468
http://dx.doi.org/10.1002/clc.23414
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