Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Heart Lung. 2013 Nov-Dec;42(6):442-7. doi: 10.1016/j.hrtlng.2013.07.012. Epub 2013 Aug 27.
Preoperative atrial fibrillation (AF) is associated with increased morbidity and mortality after open heart surgery. However, the impact of preoperative AF on long-term survival after open heart surgery has not been widely examined in rural populations. Patients from rural regions are less likely to receive treatment for cardiac conditions and to have adequate medical insurance coverage.
To examine the influence of preoperative AF on long-term survival following open heart surgery in rural eastern North Carolina.
Long-term survival was compared in patients with and without preoperative AF after coronary artery bypass grafting (CABG) and CABG plus valve (CABG + V) surgery between 2002 and 2011. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model.
The study population consisted of 5438 patients. A total of 263 (5%) patients had preoperative AF. Preoperative AF was an independent predictor of long-term survival (open heart surgery: adjusted HR = 1.6, 95% CI = 1.3-2.0; CABG: adjusted HR = 1.6, 95% CI = 1.3-2.1; CABG + V: adjusted HR = 1.6, 95% CI = 1.1-2.3).
Preoperative AF is an important predictor of long-term survival after open heart surgery in this rural population.
术前心房颤动（AF）与心脏直视手术后发病率和死亡率增加有关。然而，术前 AF 对心脏直视手术后长期生存的影响在农村人群中尚未得到广泛研究。农村地区的患者接受心脏治疗的可能性较小，且拥有充分医疗保险的可能性也较低。
在北卡罗来纳州东部农村地区，研究术前 AF 对心脏直视手术后长期生存的影响。
在 2002 年至 2011 年间，比较了冠状动脉旁路移植术（CABG）和 CABG 加瓣膜（CABG+V）手术后合并术前 AF 与无术前 AF 的患者的长期生存情况。使用 Cox 回归模型计算危险比（HR）和 95%置信区间（CI）。
研究人群由 5438 名患者组成。共有 263（5%）名患者术前存在 AF。术前 AF 是长期生存的独立预测因素（心脏直视手术：调整后的 HR = 1.6，95%CI = 1.3-2.0；CABG：调整后的 HR = 1.6，95%CI = 1.3-2.1；CABG+V：调整后的 HR = 1.6，95%CI = 1.1-2.3）。
在这个农村人群中，术前 AF 是心脏直视手术后长期生存的一个重要预测因素。
