Abstract 17968: Concomitant Atrial Fibrillation Surgery Does Not Increase the Risk for Mortality and Morbidity After Coronary Artery Bypass Grafting
Introduction: As a result of the increasing age of patients requiring myocardial revascularization for ischemic heart disease, preexisting atrial fibrillation (AF) is increasing among the patients who undergo coronary artery bypass grafting (CABG). However the impact of concomitant AF surgery on the early outcomes in patients after CABG remains unknown. The aim of this study was to assess the influences of concomitant AF surgery on the risk for mortality and morbidity after CABG.
Methods: By using the Japan Adult Cardiovascular Surgery Database (JACVSD), the outcomes of patients with preoperative AF who underwent CABG were analyzed and compared between patients who underwent concomitant AF surgery with CABG and isolated CABG without AF surgery. A logistic regression model was used to assess whether concomitant AF surgery increased risk in CABG cohort and propensity-matched analysis was also performed based on preoperative variables.
Results: From January 2004 to December 2008, a total of 19,495 patients underwent first-time CABG and 905 (4.6%) patients of them had preoperative AF. Of these, 253 (28.0%) patients had a concomitant AF surgery (AF surgery group) and 652 patients underwent isolated CABG (isolated CABG group). Overall, operative mortality (2.0% in AF surgery group, 3.1% in isolated CABG group) and major morbidity (18.6% in AF surgery group, 20.9% in isolated CABG group) were similar, and concomitant AF surgery did not have a significantly higher risk of mortality (odds ratio =0.78, 95% confidence interval 0.22-2.73; p=0.70) or major morbidity (odds ratio =1.11, 95% confidence interval 0.67-1.82; p=0.69).The propensity score matching analysis identified each 144 patients in both groups and neither operative mortality (2.8% in AF surgery group, 2.1% in isolated CABG group, p=0.70) nor major morbidity (18.8% in AF surgery group, 19.4% in isolated CABG group, p=0.88) had significant deference.
Conclusions: From the analysis of overall data of JACVSD, mortality and major morbidity were slightly higher in isolated CABG group and it supposed that AF correction surgery might be performed in lower risk patients. Even after propensity matching, concomitant AF surgery was performed safely without increasing the risk for mortality and morbidity.
- © 2011 by American Heart Association, Inc.