title: Transient post-operative atrial fibrillation predicts short and long term adverse events following CABG.
abstract: OBJECTIVE
  To assess the relationship between the development of transient post-operative atrial fibrillation (TPOAF) following coronary artery bypass graft (CABG) surgery and risk of long-term mortality.
  
  
  BACKGROUND
  Atrial fibrillation (AF) following CABG is common and associated with increased morbidity and mortality in the perioperative period. However the impact of TPOAF and its management on long-term morbidity and mortality in patients undergoing first time, isolated CABG surgery remains unclear.
  
  
  METHODS
  The Cleveland Clinic Cardiovascular Information Registry was used to identify 5,205 consecutive patients who underwent CABG between January 1993 and December 2005. Patients with TPOAF (n=1,490) were compared to those without post-operative AF (n=3,645) for the endpoints of death, myocardial infarction (MI), or stroke at 1 year.
  
  
  RESULTS
  Overall rates of 1-year mortality, MI and stroke were 3.7%, 0.8%, and 2.6%, respectively. Patients with TPOAF had an increased risk of death at 1 year as compared to patients without POAF (6.4% vs. 2.7%; P<0.001), but there was not an increased risk of stroke or MI. Multivariate analysis identified TPOAF as an independent predictor of death at 1 year (HR 1.89, 95% CI, 1.42-2.53; P<0.001). After propensity matching, patients who developed TPOAF experienced a significantly increased risk of death compared with those without TPOAF (HR 1.96, 95% CI, 1.34-2.86; P<0.001).
  
  
  CONCLUSIONS
  In patients undergoing first time, isolated CABG, the presence of TPOAF identifies a subgroup of patients at increased risk for all-cause mortality. Future prospective studies to determine potential beneficial interventions in this large population are warranted.
authors.affiliation: Sones Cardiac Catheterization Laboratory, Cleveland Clinic, Cleveland, Ohio 441195, USA.
authors.forename: Femi
authors.initials: F
authors.lastname: Philip
authors.affiliation: Sones Cardiac Catheterization Laboratory, Cleveland Clinic, Cleveland, Ohio 441195, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Becker
authors.affiliation: Sones Cardiac Catheterization Laboratory, Cleveland Clinic, Cleveland, Ohio 441195, USA.
authors.forename: John
authors.initials: J
authors.lastname: Galla
authors.affiliation: Sones Cardiac Catheterization Laboratory, Cleveland Clinic, Cleveland, Ohio 441195, USA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Blackstone
authors.affiliation: Sones Cardiac Catheterization Laboratory, Cleveland Clinic, Cleveland, Ohio 441195, USA.
authors.forename: Samir R
authors.initials: SR
authors.lastname: Kapadia
keywords: Atrial fibrillation (AF); antiarrhythmics; anticoagulation; beta blockers; coronary artery bypass graft (CABG); coronary artery disease (CAD); statins