title: Impact of race and postoperative atrial fibrillation on long-term survival after coronary artery bypass grafting.
abstract: OBJECTIVE
  Postoperative atrial fibrillation (POAF) is a known predictor of in-hospital morbidity and short-term survival after coronary artery bypass grafting (CABG). The impact of race and long-term survival has not been examined in this population. We aimed to examine the influence of these factors on long-term survival in patients undergoing CABG.
  
  
  METHODS
  Patients undergoing first-time, isolated CABG between 1992 and 2011 were included in this study. Long-term survival was compared in patients with and without POAF and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model.
  
  
  RESULTS
  A total of 2,907 (22%) patients developed POAF (black n=370; white n=2,537) following CABG (N=13,165). Median follow-up for study participants was 8.2 years. Long-term survival after CABG differed by POAF status and race (no POAF: HR=1.0; white POAF: adjusted HR=1.1, 95% CI=1.06-1.2; black POAF: adjusted HR=1.4, 95% CI=1.2-1.6; pTrend=0.0002). lack POAF patients also died sooner after surgery than their white counterparts (adjusted HR=1.2, 95% CI=1.02-1.4).
  
  
  CONCLUSIONS
  Black race was a statistically significant predictor of decreased survival among POAF patients after CABG. This finding provides useful outcome information for surgeons and their patients.
authors.affiliation: Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors.forename: Wesley T
authors.initials: WT
authors.lastname: O'Neal
authors.forename: Jimmy T
authors.initials: JT
authors.lastname: Efird
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Davies
authors.forename: Jason B
authors.initials: JB
authors.lastname: O'Neal
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Anderson
authors.forename: T Bruce
authors.initials: TB
authors.lastname: Ferguson
authors.forename: W Randolph
authors.initials: WR
authors.lastname: Chitwood
authors.forename: Alan P
authors.initials: AP
authors.lastname: Kypson
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology*; D044383:Black People / Q000706:statistics & numerical data*; D015331:Cohort Studies; D016001:Confidence Intervals; D001026:Coronary Artery Bypass / Q000401:mortality*; D005500:Follow-Up Studies; D005544:Forecasting; D017052:Hospital Mortality; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D044465:White People