冠状动脉旁路移植术后短期心房颤动发作对长期心房颤动和缺血性卒中发生率的影响。

Effects of Short-Term Episodes of Atrial Fibrillation after Coronary Artery Bypass Grafting on the Long-term Incidence of Atrial Fibrillation and Ischemic Stroke.

机构信息

Department of Cardiology, Capital Medical University Affiliated Beijing Friendship Hospital, 100050 Beijing, China.

Department of Cardiology, Capital Medical University Affiliated Beijing Anzhen Hospital, 100029 Beijing, China.

出版信息

Heart Surg Forum. 2024 Jan 10;27(1):E014-E019. doi: 10.59958/hsf.6787.

DOI:10.59958/hsf.6787

PMID:38286644

Abstract

BACKGROUND

To explore whether postoperative atrial fibrillation (POAF) has an impact on the incidence of late atrial fibrillation (AF) and late ischemic stroke after isolated coronary artery bypass grafting (CABG) compared to non-POAF patients.

METHODS

A total of 243 eligible patients were followed for five years, and divided into a POAF group (n = 69) and a non-POAF group (n = 174). The primary end point was the incidence of late AF, and late ischemic stroke. Kaplan-Meier analyses and Cox proportional hazards models were used to examine whether POAF is an independent risk factor for the occurrence of late AF and late ischemic stroke.

RESULTS

POAF patients were older than non-POAF patients. During the 5-year follow-up, the late occurrence of AF was significantly higher in POAF patients than in non-POAF (15.9% vs. 7.9% p = 0.006). There was no significant difference in the incidence of late ischemic stroke between POAF and non-POAF groups (p = 0.406). COX proportional regression analysis showed that POAF was independently associated with the late occurrence of AF (hazard ratio (HR) 3.27; 95% confidence interval (CI): 1.33-8.03, p = 0.01).

CONCLUSION

POAF is an independent risk factor for the occurrence of late AF but not stroke after isolated CABG.

摘要

背景

探讨与非 POAF 患者相比，术后心房颤动（POAF）是否会影响孤立冠状动脉旁路移植术（CABG）后晚期心房颤动（AF）和晚期缺血性卒中的发生率。

方法

共纳入 243 例符合条件的患者进行了 5 年随访，分为 POAF 组（n = 69）和非 POAF 组（n = 174）。主要终点是晚期 AF 和晚期缺血性卒中的发生率。采用 Kaplan-Meier 分析和 Cox 比例风险模型来检验 POAF 是否为晚期 AF 和晚期缺血性卒中发生的独立危险因素。

结果

POAF 患者比非 POAF 患者年龄更大。在 5 年随访期间，POAF 患者的晚期 AF 发生率明显高于非 POAF 患者（15.9%比 7.9%，p = 0.006）。POAF 组与非 POAF 组晚期缺血性卒中的发生率无显著差异（p = 0.406）。COX 比例风险回归分析显示，POAF 与晚期 AF 的发生独立相关（风险比（HR）3.27；95%置信区间（CI）：1.33-8.03，p = 0.01）。