Title |
Sex Differences in the Epidemiology of New-Onset In-Hospital Post–Coronary Artery Bypass Graft Surgery Atrial Fibrillation
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Published in |
Circulation: Cardiovascular Quality & Outcomes, October 2016
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DOI | 10.1161/circoutcomes.116.003023 |
Pubmed ID | |
Authors |
Giovanni Filardo, Gorav Ailawadi, Benjamin D Pollock, Briget da Graca, Danielle M Sass, Teresa K Phan, Debbie E Montenegro, Vinod Thourani, Ralph Damiano |
Abstract |
New-onset atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG) is associated with increased morbidity and poorer long-term survival. Although many studies show differences in outcome in women versus men after CABG, little is known about the sex-specific incidence and characteristics of post-CABG AF. Overall, 11 236 consecutive patients without preoperative AF underwent isolated CABG from 2002 to 2010 at 4 US academic medical centers and 1 high-volume specialty cardiac hospital. Data routinely collected for the Society of Thoracic Surgeons database were augmented with details on new-onset post-CABG AF events detected via continuous in-hospital ECG/telemetry monitoring. Unadjusted incidence of post-CABG AF was 29.5% (3312/11 236) overall, 30.2% (2485/8214) in men, and 27.4% (827/3022) in women. After adjustment for Society of Thoracic Surgeons-recognized risk factors, women had significantly lower risk for post-CABG AF (odds ratio [95% confidence interval]=0.75 [0.64-0.89]), shorter first, longest, and total duration of AF episodes (mean difference [95% confidence interval]=-2.7 [-4.7 to -0.8] hours; -4.1 [-6.9 to -1.2] hours; -2.4 [-2.5 to -2.3] hours, respectively). At 48 hours, AF-free probabilities were 77% for women and 72% for men (P<0.001). Number of episodes (P=0.18), operative mortality (P=0.048), stroke (P=0.126), and discharge in AF (P=0.234) did not differ significantly by sex. These novel data on sex-specific characteristics of new-onset AF after isolated CABG show that women had lower adjusted risk for post-CABG AF and experienced shorter episodes. Investigation of sex-specific impacts on outcomes is needed to identify optimal strategies for prevention and management to ensure all patients achieve the best possible outcomes. |
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Geographical breakdown
Country | Count | As % |
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United Kingdom | 1 | 2% |
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Demographic breakdown
Readers by professional status | Count | As % |
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Student > Master | 8 | 15% |
Student > Postgraduate | 7 | 13% |
Student > Bachelor | 5 | 9% |
Student > Ph. D. Student | 5 | 9% |
Student > Doctoral Student | 4 | 8% |
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Unknown | 13 | 25% |
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Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
Other | 2 | 4% |
Unknown | 14 | 26% |