Risk factors and prognosis of delayed-onset atrial fibrillation after cardiac surgery: a multicenter retrospective cohort study
10.3760/cma.j.cn112434-20240909-00218
- VernacularTitle:心脏术后迟发性心房颤动的危险因素和预后分析：一项多中心回顾性队列研究
- Author:
Yukai WU
1
;
Yue XIAO
;
Yueyue XU
;
Wen CHEN
;
Changchun CAO
;
Xin CHEN
;
Cunhua SU
Author Information
1. 东南大学医学院，南京 210000
- Publication Type:Journal Article
- Keywords:
Cardiac surgery;
Delayed-onset postoperative atrial fibrillation;
CHA2DS2-VASc score;
Risk factors;
Prognosis
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(5):257-263
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors and prognosis of postoperative atrial fibrillation(POAF) and delayed-onset POAF(dPOAF).Methods:In a retrospective cohort study involving consecutive patients who underwent cardiac surgery across provincial cardiovascular consortium consisted of 57 hospitals in Jiangsu Province from January 2015 to December 2022, the incidence and implications of dPOAF were examined. dPOAF was defined as being diagnosed within 30 days of discharge.Results:Among 2 788 patients with postoperative new-onset POAF, 154(5.5%)cases had dPOAF, median onset time 21(15, 26)days following surgery. Compared to in-patient diagnosed POAF, dPOAF was associated with increased rates of hypertension(28.6% vs. 9.0%, P<0.001), diabetes(10.4% vs. 3.2%, P<0.001), heart failure(39.6% vs. 19.3%, P<0.001), peripheral vascular disease(13.6% vs. 2.2%, P<0.001), and higher CHA2DS2-VASc score(≥2)(59.8% vs. 43.2%, P<0.001). Female patients were less likely to develop dPOAF( OR=0.44, 95% CI: 0.30-0.63, P<0.001). During follow-up period, there was no significant difference in major adverse cardiovascular events(MACEs)( HR=1.33, 95% CI: 0.82-2.17), overall mortality( HR=0.58, 95% CI: 0.07-4.67), or thromboembolism events( HR=0.57, 95% CI: 0.26-1.25). Conclusion:This study underscores the risk factors and prognosis associated with dPOAF compared to in-hospital POAF. It highlights the imperative for vigilant monitoring and individualized management strategies tailored to patients at risk of dPOAF.
