title: Sex Differences in the Epidemiology of New-Onset In-Hospital Post-Coronary Artery Bypass Graft Surgery Atrial Fibrillation: A Large Multicenter Study.
abstract: New-onset atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG) is associated with increased morbidity and poorer long-term survival. Although many studies show differences in outcome in women versus men after CABG, little is known about the sex-specific incidence and characteristics of post-CABG AF.
  
  
  
  Overall, 11 236 consecutive patients without preoperative AF underwent isolated CABG from 2002 to 2010 at 4 US academic medical centers and 1 high-volume specialty cardiac hospital. Data routinely collected for the Society of Thoracic Surgeons database were augmented with details on new-onset post-CABG AF events detected via continuous in-hospital ECG/telemetry monitoring. Unadjusted incidence of post-CABG AF was 29.5% (3312/11 236) overall, 30.2% (2485/8214) in men, and 27.4% (827/3022) in women. After adjustment for Society of Thoracic Surgeons-recognized risk factors, women had significantly lower risk for post-CABG AF (odds ratio [95% confidence interval]=0.75 [0.64-0.89]), shorter first, longest, and total duration of AF episodes (mean difference [95% confidence interval]=-2.7 [-4.7 to -0.8] hours; -4.1 [-6.9 to -1.2] hours; -2.4 [-2.5 to -2.3] hours, respectively). At 48 hours, AF-free probabilities were 77% for women and 72% for men (P<0.001). Number of episodes (P=0.18), operative mortality (P=0.048), stroke (P=0.126), and discharge in AF (P=0.234) did not differ significantly by sex.
  
  
  
  These novel data on sex-specific characteristics of new-onset AF after isolated CABG show that women had lower adjusted risk for post-CABG AF and experienced shorter episodes. Investigation of sex-specific impacts on outcomes is needed to identify optimal strategies for prevention and management to ensure all patients achieve the best possible outcomes.
authors.affiliation: From the Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX (G.F., B.D.P., B.d.G., D.M.S., T.K.P., D.E.M.); The Heart Hospital Baylor Plano, TX (G.F.); Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville (G.A.); Division of Cardiothoracic Surgery, Emory University, Atlanta, GA (V.T.); and Department of Cardiac Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St Louis, MO (R.D.). giovanfi@baylorhealth.edu.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Filardo
authors.affiliation: From the Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX (G.F., B.D.P., B.d.G., D.M.S., T.K.P., D.E.M.); The Heart Hospital Baylor Plano, TX (G.F.); Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville (G.A.); Division of Cardiothoracic Surgery, Emory University, Atlanta, GA (V.T.); and Department of Cardiac Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St Louis, MO (R.D.).
authors.forename: Gorav
authors.initials: G
authors.lastname: Ailawadi
authors.affiliation: From the Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX (G.F., B.D.P., B.d.G., D.M.S., T.K.P., D.E.M.); The Heart Hospital Baylor Plano, TX (G.F.); Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville (G.A.); Division of Cardiothoracic Surgery, Emory University, Atlanta, GA (V.T.); and Department of Cardiac Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St Louis, MO (R.D.).
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Pollock
authors.affiliation: From the Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX (G.F., B.D.P., B.d.G., D.M.S., T.K.P., D.E.M.); The Heart Hospital Baylor Plano, TX (G.F.); Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville (G.A.); Division of Cardiothoracic Surgery, Emory University, Atlanta, GA (V.T.); and Department of Cardiac Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St Louis, MO (R.D.).
authors.forename: Briget
authors.initials: B
authors.lastname: da Graca
authors.affiliation: From the Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX (G.F., B.D.P., B.d.G., D.M.S., T.K.P., D.E.M.); The Heart Hospital Baylor Plano, TX (G.F.); Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville (G.A.); Division of Cardiothoracic Surgery, Emory University, Atlanta, GA (V.T.); and Department of Cardiac Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St Louis, MO (R.D.).
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Sass
authors.affiliation: From the Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX (G.F., B.D.P., B.d.G., D.M.S., T.K.P., D.E.M.); The Heart Hospital Baylor Plano, TX (G.F.); Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville (G.A.); Division of Cardiothoracic Surgery, Emory University, Atlanta, GA (V.T.); and Department of Cardiac Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St Louis, MO (R.D.).
authors.forename: Teresa K
authors.initials: TK
authors.lastname: Phan
authors.affiliation: From the Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX (G.F., B.D.P., B.d.G., D.M.S., T.K.P., D.E.M.); The Heart Hospital Baylor Plano, TX (G.F.); Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville (G.A.); Division of Cardiothoracic Surgery, Emory University, Atlanta, GA (V.T.); and Department of Cardiac Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St Louis, MO (R.D.).
authors.forename: Debbie E
authors.initials: DE
authors.lastname: Montenegro
authors.affiliation: From the Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX (G.F., B.D.P., B.d.G., D.M.S., T.K.P., D.E.M.); The Heart Hospital Baylor Plano, TX (G.F.); Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville (G.A.); Division of Cardiothoracic Surgery, Emory University, Atlanta, GA (V.T.); and Department of Cardiac Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St Louis, MO (R.D.).
authors.forename: Vinod
authors.initials: V
authors.lastname: Thourani
authors.affiliation: From the Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX (G.F., B.D.P., B.d.G., D.M.S., T.K.P., D.E.M.); The Heart Hospital Baylor Plano, TX (G.F.); Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville (G.A.); Division of Cardiothoracic Surgery, Emory University, Atlanta, GA (V.T.); and Department of Cardiac Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St Louis, MO (R.D.).
authors.forename: Ralph
authors.initials: R
authors.lastname: Damiano
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D016208:Databases, Factual; D004562:Electrocardiography; D005260:Female; D061847:Hospitals, High-Volume; D006801:Humans; D007297:Inpatients; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D057216:Propensity Score; D016016:Proportional Hazards Models; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: atrial fibrillation; coronary artery bypass; epidemiology; morbidity; risk factor; women