title: New onset postoperative atrial fibrillation is associated with a long-term risk for stroke and death following cardiac surgery.
abstract: OBJECTIVE
  We sought to evaluate the long-term impact of post-cardiac surgery atrial fibrillation on the risk of stroke and survival.
  
  
  METHODS
  Patients undergoing isolated CABG surgery from April 1, 1995 to March 31, 2007 were identified (n = 8058). Long-term stroke data were compiled using Cox modeling adjusted for clinical characteristics comparing patients with new-onset atrial fibrillation (NwAfib) and those without.
  
  
  RESULTS
  NwAfib developed in 2214 patients (27.5%). Overall in-hospital mortality was 2.4% and was not different between groups. Unadjusted in-hospital outcomes suggest patients with NwAfib were more likely to suffer a permanent stroke (1% vs 2.5%; p < 0.001) require prolonged mechanical ventilation (p < 0.001) and prolonged stay in hospital (p < 0.001). After discharge patients were followed for a mean of 5.7 years. Stroke was reported in 268 (12.1%) patients in the NwAfib group compared to others (8.4%). After adjustment NwAfib was independently associated with a higher risk for stroke with a hazard ratio of 1.26 (1.08-1.47; p = 0.0034) and a higher risk of death with a hazard ratio of 1.2 (1.08-1.32; p = 0.0007).
  
  
  CONCLUSIONS
  Patients with NwAfib perioperatively have increased risk of stroke and early death after discharge independent of other clinical risk factors.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Horwich
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Buth
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Légaré
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation; D015331:Cohort Studies; D047549:Coronary Artery Bypass, Off-Pump / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D013997:Time Factors