Impact of race and postoperative atrial fibrillation on long-term survival after coronary artery bypass grafting

J Card Surg. 2013 Sep;28(5):484-91. doi: 10.1111/jocs.12178. Epub 2013 Aug 2.

Abstract

Background and aim: Postoperative atrial fibrillation (POAF) is a known predictor of in-hospital morbidity and short-term survival after coronary artery bypass grafting (CABG). The impact of race and long-term survival has not been examined in this population. We aimed to examine the influence of these factors on long-term survival in patients undergoing CABG.

Methods: Patients undergoing first-time, isolated CABG between 1992 and 2011 were included in this study. Long-term survival was compared in patients with and without POAF and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model.

Results: A total of 2,907 (22%) patients developed POAF (black n=370; white n=2,537) following CABG (N=13,165). Median follow-up for study participants was 8.2 years. Long-term survival after CABG differed by POAF status and race (no POAF: HR=1.0; white POAF: adjusted HR=1.1, 95% CI=1.06-1.2; black POAF: adjusted HR=1.4, 95% CI=1.2-1.6; pTrend=0.0002). lack POAF patients also died sooner after surgery than their white counterparts (adjusted HR=1.2, 95% CI=1.02-1.4).

Conclusion: Black race was a statistically significant predictor of decreased survival among POAF patients after CABG. This finding provides useful outcome information for surgeons and their patients.

MeSH terms

  • Aged
  • Atrial Fibrillation / epidemiology*
  • Black People / statistics & numerical data*
  • Cohort Studies
  • Confidence Intervals
  • Coronary Artery Bypass / mortality*
  • Follow-Up Studies
  • Forecasting
  • Hospital Mortality
  • Humans
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • White People