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Increased late mortality after coronary artery bypass surgery complicated by isolated new-onset atrial fibrillation: A comprehensive propensity-matched analysis

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dc.contributor.author Al-Shaar L.
dc.contributor.author Schwann T.A.
dc.contributor.author Kabour A.
dc.contributor.author Habib R.H.
dc.contributor.editor
dc.date 2014
dc.date.accessioned 2017-10-05T16:08:59Z
dc.date.available 2017-10-05T16:08:59Z
dc.date.issued 2014
dc.identifier 10.1016/j.jtcvs.2014.05.020
dc.identifier.isbn
dc.identifier.issn 00225223
dc.identifier.uri http://hdl.handle.net/10938/20170
dc.description.abstract Objectives: The association of new-onset postoperative atrial fibrillation (POAF) and late death after coronary artery bypass grafting (CABG) has been confounded by the frequent concomitant serious complications that co-occur with POAF. We aimed to define the magnitude and time dependence of the effect of isolated POAF on late survival after uncomplicated CABG to comprehensively account for comorbidity and perioperative confounding factors. Methods: Nonsalvage CABG patients with no history of AF, no concomitant aortic or valvular surgery, and no perioperative complications other than POAF were studied (n = 6305). Patients were divided into AF (n = 1211, 68 years old, 72percent male) and no-AF (n = 5094, 63 years old, 70percent male) groups. Propensity matching was done using 55 patient variables, including coronary grafts, completeness of revascularization, and transfusion data. The AF effect was quantified using time-segmented hazard ratios by Cox regression analysis. Results: Single (1-to-1), double (1-to-2), and triple (1-to-3) propensity matching of the AF and no-AF was achieved for 1196, 993, and 719 cases, respectively. The AF group showed significantly worse, yet time-varying, 0- to 18-year survival: 0 to 1 year, HR, 1.18 (95percent confidence interval, 0.77-1.81); 1 to 6 years, HR, 1.37 (95percent confidence interval, 1.12 to 1.67); and 6 to 17 years, HR, 1.25 (95percent confidence interval, 1.05 to 1.49). Conclusions: Isolated POAF was associated with a time-varying increase in mortality after CABG. Given these findings and the high incidence of POAF, efforts to reduce POAF should be pursued to potentially improve resource usage, morbidity, and mortality. © 2014 The American Association for Thoracic Surgery.
dc.format.extent
dc.language English
dc.publisher NEW YORK
dc.relation.ispartof Publication Name: Journal of Thoracic and Cardiovascular Surgery; Publication Year: 2014;
dc.relation.ispartofseries
dc.relation.uri
dc.source Scopus
dc.subject.other
dc.title Increased late mortality after coronary artery bypass surgery complicated by isolated new-onset atrial fibrillation: A comprehensive propensity-matched analysis
dc.type Article in Press
dc.contributor.affiliation Al-Shaar, L., Vascular Medicine Program, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Schwann, T.A., Department of Surgery, University of Toledo College of Medicine, Toledo, Ohio
dc.contributor.affiliation Kabour, A., Mercy Saint Vincent Medical Center, Toledo, Ohio
dc.contributor.affiliation Habib, R.H., Vascular Medicine Program, American University of Beirut, Beirut, Lebanon, Outcomes Research Unit and Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
dc.contributor.authorAddress Habib, R.H.; Vascular Medicine Program, American University of Beirut, Beirut, Lebanonemail: rh106@aub.edu.lb
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Vascular Medicine Program;
dc.contributor.authorDepartment Vascular Medicine Program
dc.contributor.authorDivision
dc.contributor.authorEmail rh106@aub.edu.lb
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Al-Shaar, L
dc.contributor.authorInitials Schwann, TA
dc.contributor.authorInitials Kabour, A
dc.contributor.authorInitials Habib, RH
dc.contributor.authorOrcidID
dc.contributor.authorReprintAddress Habib, RH (reprint author), Amer Univ, Beirut Med Ctr, Outcomes Res Unit, POB 11-0236, Beirut 11072020, Lebanon.
dc.contributor.authorResearcherID
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedTotWOSCount 1
dc.description.citedWOSCount 1
dc.format.extentCount 1
dc.identifier.articleNo
dc.identifier.coden JTCSA
dc.identifier.pubmedID
dc.identifier.scopusID 84901885378
dc.identifier.url
dc.publisher.address 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
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dc.relation.ispartofConferenceTitle
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dc.relation.ispartOfISOAbbr J. Thorac. Cardiovasc. Surg.
dc.relation.ispartOfIssue
dc.relation.ispartOfPart
dc.relation.ispartofPubTitle Journal of Thoracic and Cardiovascular Surgery
dc.relation.ispartofPubTitleAbbr J. Thorac. Cardiovasc. Surg.
dc.relation.ispartOfSpecialIssue
dc.relation.ispartOfSuppl
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dc.source.ID WOS:000345132600033
dc.type.publication Journal
dc.subject.otherAuthKeyword
dc.subject.otherChemCAS
dc.subject.otherIndex
dc.subject.otherKeywordPlus LONG-TERM SURVIVAL
dc.subject.otherKeywordPlus INTERNAL THORACIC ARTERY
dc.subject.otherKeywordPlus CARDIAC-SURGERY
dc.subject.otherKeywordPlus RADIAL ARTERY
dc.subject.otherKeywordPlus HEART-FAILURE
dc.subject.otherKeywordPlus RISK
dc.subject.otherKeywordPlus TRANSFUSION
dc.subject.otherKeywordPlus IMPACT
dc.subject.otherKeywordPlus GRAFT
dc.subject.otherKeywordPlus PREDICTORS
dc.subject.otherWOS Cardiac and Cardiovascular Systems
dc.subject.otherWOS Respiratory System
dc.subject.otherWOS Surgery


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