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Sex Differences in the Epidemiology of New-Onset In-Hospital Post–Coronary Artery Bypass Graft Surgery Atrial Fibrillation
- Source :
- Circulation: Cardiovascular Quality and Outcomes. 9:723-730
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
Abstract
- Background— 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. Methods and Results— 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 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. Conclusions— 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.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Databases, Factual
030204 cardiovascular system & hematology
Lower risk
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Atrial Fibrillation
Epidemiology
Odds Ratio
medicine
Humans
030212 general & internal medicine
Coronary Artery Bypass
Sex Distribution
Risk factor
Propensity Score
Stroke
Aged
Proportional Hazards Models
Academic Medical Centers
Inpatients
business.industry
Incidence (epidemiology)
Atrial fibrillation
Odds ratio
Middle Aged
medicine.disease
United States
Confidence interval
Surgery
Logistic Models
Treatment Outcome
Multivariate Analysis
Linear Models
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Hospitals, High-Volume
Subjects
Details
- ISSN :
- 19417705 and 19417713
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Circulation: Cardiovascular Quality and Outcomes
- Accession number :
- edsair.doi.dedup.....de6d675cc6c4c4a442ee926ace0e2abe