O'Neal Wesley T, Efird Jimmy T, Davies Stephen W, O'Neal Jason B, Anderson Curtis A, Ferguson T Bruce, Chitwood W Randolph, Kypson Alan P
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
J Card Surg. 2013 Sep;28(5):484-91. doi: 10.1111/jocs.12178. Epub 2013 Aug 2.
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.
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.
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).
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.
术后心房颤动（POAF）是冠状动脉旁路移植术（CABG）后院内发病率和短期生存的已知预测指标。种族和长期生存的影响尚未在该人群中进行研究。我们旨在研究这些因素对接受CABG患者长期生存的影响。
本研究纳入了1992年至2011年间首次接受单纯CABG的患者。比较有无POAF患者的长期生存情况，并按种族进行分层。使用Cox回归模型计算风险比（HR）和95%置信区间（CI）。
在13165例CABG患者中，共有2907例（22%）发生POAF（黑人n = 370；白人n = 2537）。研究参与者的中位随访时间为8.2年。CABG后的长期生存因POAF状态和种族而异（无POAF：HR = 1.）；白人POAF：调整后HR = 1.1，95% CI = 1.06 - 1.2；黑人POAF：调整后HR = 1.4，95% CI = 1.
黑人种族是CABG后POAF患者生存降低的统计学显著预测指标。这一发现为外科医生及其患者提供了有用的预后信息。 （注：原文中“白人POAF：调整后HR = 1.1，95% CI = 1.06 - 1.2；黑人POAF：调整后HR = 1.4，95% CI = 1.2 - 1.6”部分的“1.”表述不完整，翻译时保留原文状态。）
