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Atrial Fibrillation Predicts Worse Long Time Prognosis after CABG – A 6-Year Survival Analysis

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DOI: 10.4236/ojts.2012.22006    3,512 Downloads   5,935 Views  
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ABSTRACT

Background: Postoperative atrial fibrillation occurs in 5% - 65% of patients undergoing cardiac surgery. Although postoperative atrial fibrillation is often regarded as a temporary, benign, operation-related problem, it is associated with a two- to threefold increased risk of adverse events, including permanent or transient stroke, acute myocardial infarction, and death. Methods: Two hundred and fifty eligible consecutively enrolled coronary artery bypass grafting patients were included in the randomized, controlled, double-blinded trial RASCABG. That study showed a safe, practical, feasible, and effective prophylactic amiodarone regimen, which significantly decreased the risk of atrial fibrillation with 14% (5.0 - 24) from 26% to 11%, with the number needed to treat 6.9 (4.2 - 20). This study is a 6-year follow-up study regarding the long-term prognostic factor of postoperative atrial fibrillation, amiodarone prophylaxis and diabetes mellitus. Results: The long-term 6-year mortality risk of postoperative atrial fibrillation was 31% equally distributed among patients in the active and in the placebo prophylactic group. The 6-year mortality risk in the sinus rhythm group was 18% likewise equally distributed, whereas the 6-year mortality risk in the background population was approximately 8%. The 6-year mortality risk of diabetes mellitus was 33% equally distributed, whereas the excluded off pump coronary artery bypass group experiences an increased 6-year mortality risk of 47%. Conclusions: Postoperative prophylaxis with a high dose of oral amiodarone after an intravenous bolus infusion is a safe, practical, feasible, and effective regimen for Coronary Artery Bypass Grafting patients in a 6-year long-term perspective. Atrial fibrillation and diabetes mellitus is correlated to increased mortality risk.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

L. Riber, "Atrial Fibrillation Predicts Worse Long Time Prognosis after CABG – A 6-Year Survival Analysis," Open Journal of Thoracic Surgery, Vol. 2 No. 2, 2012, pp. 18-22. doi: 10.4236/ojts.2012.22006.

References

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