Impact of Hispanic ethnicity on the likelihood of developing postoperative atrial fibrillation.
BACKGROUND
A recent multicenter observational study of 4,657 patients reported a 52% lower risk of postcardiothoracic surgery (CTS) atrial fibrillation (AF) among South American vs United States patients. This study did not evaluate whether the decreased incidence in AF was attributable to differing ethnicity (Hispanic vs Caucasian) or to another cause.


METHODS
A cohort study of CTS patients at Hartford Hospital was undertaken to evaluate whether Hispanic patients had a lower incidence of post-CTS AF than Caucasians. First, Hispanic patients were compared to the total Caucasian population. Then differences in important baseline predictors of AF were probed between groups. Finally, Hispanic patients undergoing CTS were matched (1:4 matching) with Caucasian patients based upon known predictors of post-CTS AF including age >70 years, valvular surgery, AF history, previous CTS, peripheral vascular disease, gender, pre-CTS digoxin and beta-blocker intolerance.


RESULTS
In the total population [n = 2,739, with 97 (3.5%) Hispanics, 66.6 +/- 11.6 years, 70.9% male, 66.9% valve surgery], Hispanics were 38% less likely to develop AF (15.5% vs 24.8%, P = 0.035). However, the Hispanic patients were 11.9 years younger (P< 0.001) with 14.7% more women (P = 0.002) which reduces the risk of post-CTS AF; they also had a 12.8% higher risk of valvular surgery (P = 0.009) which is known to enhance the risk. When these factors and other important variables were matched for, a total of 485 patients (n = 97 Hispanics, 388 Caucasian) were evaluated (55.8 +/- 13.1 years, 57.3% male, 45.4% valvular surgery). Hispanic and Caucasian patients had a similar incidence of post-CTS AF (15.5% vs 18.3%, P = 0.513).


CONCLUSIONS
Hispanic patients do not have an innately lower risk of post-CTS AF than Caucasians.
Gryskiewicz
Kristen A
KA
University of Connecticut School of Pharmacy, Hartford, USA.
Gillespie
Effie L
EL
White
C Michael
CM
Kluger
Jeffrey
J
Gallagher
Robert
R
Coleman
Craig I
CI
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data