dc.contributor.author |
Rezk, Mary |
dc.contributor.author |
Taha, Amar |
dc.contributor.author |
Nielsen, Susanne J |
dc.contributor.author |
Martinsson, Andreas |
dc.contributor.author |
Bergfeldt, Lennart |
dc.contributor.author |
Guðbjartsson, Tómas |
dc.contributor.author |
Franzén, Stefan |
dc.contributor.author |
Jeppsson, Anders |
dc.date.accessioned |
2024-01-13T01:05:49Z |
dc.date.available |
2024-01-13T01:05:49Z |
dc.date.issued |
2023-05-02 |
dc.identifier.citation |
Rezk , M , Taha , A , Nielsen , S J , Martinsson , A , Bergfeldt , L , Guðbjartsson , T , Franzén , S & Jeppsson , A 2023 , ' Associations between new-onset postoperative atrial fibrillation and long-term outcome in patients undergoing surgical aortic valve replacement ' , European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery , vol. 63 , no. 5 , ezad103 . https://doi.org/10.1093/ejcts/ezad103 |
dc.identifier.issn |
1010-7940 |
dc.identifier.other |
113531673 |
dc.identifier.other |
5d186c2a-e749-4fa0-9fba-0a4ddad41f6a |
dc.identifier.other |
36961335 |
dc.identifier.other |
unpaywall: 10.1093/ejcts/ezad103 |
dc.identifier.other |
85180267368 |
dc.identifier.uri |
https://hdl.handle.net/20.500.11815/4644 |
dc.description |
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. |
dc.description.abstract |
OBJECTIVES: Data on prognostic implications of new-onset postoperative atrial fibrillation (POAF) after surgical aortic valve replacement (SAVR) is limited. We sought to explore associations between POAF, early initiated oral anticoagulation (OAC) and long-term outcome after SAVR and combined SAVR + coronary artery bypass grafting (CABG). METHODS: This is a retrospective, population-based study including all isolated SAVR (n = 7038) and combined SAVR and CABG patients (n = 3854) without a history of preoperative atrial fibrillation (AF) in Sweden 2007-2017. Individual patient data were merged from 4 nationwide registries. Inverse probability of treatment weighting-adjusted Cox regression models were employed separately in SAVR and SAVR + CABG patients. The median follow-up time was 4.7 years (range 0-10 years). RESULTS: POAF occurred in 44.5% and 50.7% of SAVR and SAVR + CABG patients, respectively. In SAVR patients, POAF was associated with increased long-term risk of death [adjusted hazard ratio (aHR) 1.21 (95% confidence interval 1.06-1.37)], ischaemic stroke [aHR 1.32 (1.08-1.59)], any thromboembolism, heart failure hospitalization and recurrent AF. In SAVR + CABG, POAF was associated with death [aHR 1.31 (1.14-1.51)], recurrent AF and heart failure, but not with ischaemic stroke [aHR 1.04 (0.84-1.29)] or thromboembolism. OAC was dispensed within 30 days after discharge to 67.0% and 65.9%, respectively, of SAVR and SAVR + CABG patients with POAF. Early initiated OAC was not associated with reduced risk of death, ischaemic stroke or thromboembolism in any group of patients. CONCLUSIONS: POAF after SAVR is associated with an increased risk of long-term mortality and morbidity. Further studies are warranted to clarify the role of OAC in SAVR patients with POAF. |
dc.format.extent |
1103387 |
dc.format.extent |
|
dc.language.iso |
en |
dc.relation.ispartofseries |
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery; 63(5) |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.subject |
Hjarta- og lungnaskurðlæknisfræði |
dc.subject |
Aortic Valve/surgery |
dc.subject |
Atrial Fibrillation/etiology |
dc.subject |
Brain Ischemia |
dc.subject |
Heart Failure/complications |
dc.subject |
Humans |
dc.subject |
Postoperative Complications/epidemiology |
dc.subject |
Retrospective Studies |
dc.subject |
Risk Factors |
dc.subject |
Stroke/epidemiology |
dc.subject |
Thromboembolism/etiology |
dc.subject |
• |
dc.subject |
Surgical aortic valve replacement |
dc.subject |
Postoperative atrial fibrillation |
dc.subject |
Coronary artery bypass grafting |
dc.subject |
Cardiology and Cardiovascular Medicine |
dc.subject |
Pulmonary and Respiratory Medicine |
dc.subject |
Surgery |
dc.title |
Associations between new-onset postoperative atrial fibrillation and long-term outcome in patients undergoing surgical aortic valve replacement |
dc.type |
/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article |
dc.description.version |
Peer reviewed |
dc.identifier.doi |
10.1093/ejcts/ezad103 |
dc.relation.url |
http://www.scopus.com/inward/record.url?scp=85180267368&partnerID=8YFLogxK |
dc.contributor.department |
Faculty of Medicine |
dc.contributor.department |
Other departments |