Postoperative atrial fibrillation following coronary artery bypass graft: clinical factors associated with in-hospital death.
OBJECTIVE
To identify factors associated with a higher likelihood of in-hospital death in patients submitted to coronary artery bypass graft surgery (CABG) who developed atrial fibrillation (AF) postoperatively.


METHODS
The authors analyzed data from 397 consecutive patients submitted to CABG that developed AF postoperatively between 2000 and 2003. The patients were divided into 2 groups: group 1 (G1) comprised patients who survived (n=369); and group 2 (G2) comprised patients who died during hospital stay (n=28). Statistical analysis was performed using Student's t test and chi-square test, and p values < 0.05 were considered significant.


RESULTS
A comparative analysis between G1 and G2 showed that there was no difference between the groups as regards age (67.3 +/- 8.4 versus 69.3 +/- 9.6; p = 0.4), male gender (75.9% versus 64.3%; p = 0.1), systemic arterial hypertension (75.3% versus 85.7%; p = 0.2) and congestive heart failure (17% versus 17%; p = 1). Group 2 presented higher rates for previous acute myocardial infarction (14.6% versus 28.6%; p = 0.05), left ventricular ejection fraction < 40% (12.2% versus 32.1%; p = 0.003), previous cerebrovascular accident (0.8% versus 17.9%; p = 0.03), previous percutaneous coronary intervention (19.5% versus 39.3%; p = 0.01) and previous CABG (19.3% versus 35.7%; p = 0.03).


CONCLUSIONS
Clinical history of acute myocardial infarction, CABG, percutaneous coronary intervention, cerebrovascular accident and severe ventricular dysfunction were significantly more frequent in the group that died during hospital stay, which suggests a possible association of these factors with a higher likelihood of death following CABG.
Oliveira
Dinaldo Cavalcanti de
DC
Hospital do Coração, Associação do Sanatório Sírio, São Paulo, SP, Brasil. dinaldo@cardiol.br
Ferro
Carlos Romério
CR
Oliveira
João Bosco de
JB
Prates
Guilherme Jose
GJ
Torres
Audrey
A
Egito
Enilton Sergio Tabosa do
ES
Arraes
Magali Santos
MS
Souza
Luis Carlos Bento de
LC
Jatene
Adib Domingos
AD
Piegas
Leopoldo Soares
LS
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000209:etiology / Q000401:mortality*; D002561:Cerebrovascular Disorders / Q000150:complications; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003327:Coronary Disease / Q000175:diagnosis / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications; D011184:Postoperative Period; D013997:Time Factors; D018754:Ventricular Dysfunction / Q000150:complications
D000889:Anti-Arrhythmia Agents