title: The impact of race and postoperative atrial fibrillation on operative mortality after elective coronary artery bypass grafting.
abstract: OBJECTIVE
  Black patients are less likely to develop postoperative atrial fibrillation (POAF) following coronary artery bypass grafting (CABG) than whites. However, the influence of race and POAF on operative mortality has not been examined. The objective of this study was to determine the influence of race and POAF on operative mortality after CABG.
  
  
  METHODS
  Patients undergoing elective CABG between 1992 and 2011 were included. Operative mortality was compared between patients with and those without new-onset POAF by race. Relative risk (RR) and 95% confidence intervals (CI) were computed using Poisson (robust variance estimates) and log-binomial regression models.
  
  
  RESULTS
  A total of 1215 (23%) patients developed POAF (white n=1060; black n=155) following CABG (N=5387). Operative mortality differed by POAF status within race category (white POAF: adjusted RR=1.4, 95% CI=0.86-2.2; black POAF: adjusted RR=5.0, 95% CI=1.9-13; Pinteraction=0.0016). Black POAF patients had a 2-fold increased risk of operative death compared with white POAF patients (Padjusted=0.052).
  
  
  CONCLUSIONS
  POAF was observed to be a stronger predictor of operative mortality in black compared with white patients undergoing elective CABG.
authors.affiliation: Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
authors.forename: Jimmy T
authors.initials: JT
authors.lastname: Efird
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Davies
authors.forename: Wesley T
authors.initials: WT
authors.lastname: O'Neal
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Anderson
authors.forename: Ethan J
authors.initials: EJ
authors.lastname: Anderson
authors.forename: Jason B
authors.initials: JB
authors.lastname: O'Neal
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: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000208:ethnology*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data*
keywords: CABG; Operative mortality; Race; Survival