A Multicenter Risk Index for Atrial Fibrillation After Cardiac Surgery

Mathew, Joseph P.; Fontes, Manuel L.; Tudor, Iulia Cristina; Ramsay, James; Duke, Peter C.; Mazer, C. David; Barash, Paul G.; Hsu, Ping H.; Mangano, Dennis T.

doi:10.1001/jama.291.14.1720

Cited by 1,073 publications

(868 citation statements)

References 29 publications

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“…The present study focused on preoperative parameters. In previous studies, advanced age, male gender, chronic HF, preoperative AF attacks, COPD, chronic renal disease, DM and rheumatic heart disease, metabolic syndrome, obesity, and inefficient beta-blocker or ACE inhibitor use were reported to be preoperative clinical parameters predicting the development of POAF [12][13][14][15]. In addition to these parameters, p-wave duration on ECG and elevated levels of B-type natriuretic peptide in the preoperative period also predicted the development of POAF [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

“…Among these, age, heart failure (HF), rheumatic heart disease, chronic kidney disease, and chronic obstructive pulmonary disease (COPD) are the most prominent clinical risk factors [8,15]. The predictive value of these risk factors depends on the results of various studies, and different risk factors have been emphasised in different studies.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of HATCH score as a predictor of atrial fibrillation after coronary artery bypass graft

et al. 2016

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A b s t r a c tBackground: Atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery is associated with increased morbidity and mortality. The HATCH score was originally devised to predict the progression of paroxysmal AF to persistent AF. Aim:To determine whether the HATCH score predicts the development of AF after CABG surgery. Methods:The medical records of 284 consecutive patients, who underwent CABG surgery between January 2013 and December 2014, were retrospectively reviewed for the development of AF in the postoperative (POAF) period. The HATCH score, and clinical and echocardiographic parameters were evaluated for all patients.Results: Seventy (25%) patients developed POAF. The HATCH scores were higher in the POAF group (2.8 ± 1.8 vs. 1.1 ± 1.2, p < 0.001). The area of the HATCH score under the curve in the receiver operating characteristics analysis was 773 (95% CI 706-841, p < 0.001). When the HATCH score was 2 or more as a threshold, there was for POAF 72% sensitivity and 75% specificity. Conclusions:The results of the present study suggest that the HATCH score can be used to predict the development of POAF.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Usefulness of HATCH score as a predictor of atrial fibrillation after coronary artery bypass graft

et al. 2016

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“…As a result, ALMT may be a less traumatic approach and therefore a less potent trigger of post-operative atrial fibrillation. Mathew et al (2004) showed that bicaval venous cannulation (most often performed for mitral valve surgery) may predispose toward recurrent atrial fibrillation as a consequence of greater surgical injury. ALMT can avoid bicaval venous cannulation by using femoral cannulation instead.…”

Section: Discussionmentioning

confidence: 99%

Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis

Ding

Jiang

Tao

et al. 2014

J. Zhejiang Univ. Sci. B

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Abstract:Objective: Mitral valve disease tends to be treated with anterolateral minithoracotomy (ALMT) rather than median sternotomy (MS), as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. Methods: One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. Results: ALMT showed a significantly longer cardiopulmonary bypass time (P=0.001) and aortic cross-clamp time (P=0.05) compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay (P<0.00001). According to operative complications, the onset of new arrhythmias following ALMT decreased significantly as compared with MS (P=0.05); however, the incidence of peri-operative mortality (P=0.62), re-operation for bleeding (P=0.37), neurologic events (P=0.77), myocardial infarction (P=0.84), gastrointestinal complications (P=0.89), and renal insufficiency (P=0.67) were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Conclusions: Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.

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“…New-onset AF linked to acute inflammation is, however, well known in surgery, both after cardiothoracic [13,14,15,16] and abdominal surgery [17, 18]. Furthermore, in some reports, infection was emphasized as an additional risk factor of postoperative AF.…”

Section: Discussionmentioning

confidence: 99%

New-Onset Atrial Fibrillation in Bacteremia Is Not Associated with C-Reactive Protein, but Is an Indicator of Increased Mortality during Hospitalization

Kindem¹,

Reindal²,

Wester³

et al. 2008

Cardiology

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Background: Several studies have associated elevated C-reactive protein (CRP) levels to the occurrence of atrial fibrillation (AF). We sought to estimate the frequency and prognostic impact of AF in patients with bacteremia, and to study the possible association between AF and CRP as well as between AF and mortality in this population. Methods: We retrospectively evaluated patient charts of patients with bacteremia with Escherichia coli or Streptococcus pneumoniae admitted to the Aker University Hospital in Oslo between 1994 and 2004. Known cardiac risk factors for AF, signs and mode of conversion of AF, and, if applicable, date of death were registered, as were characteristics of infection, such as systemic inflammatory response syndrome and white blood cell count. Initial CRP values were categorized into 4 strata. Odds ratios of the 3 highest CRP categories compared with the lowest were obtained from logistic models adjusting for known cardiac risk factors for AF as well as possible factors that may have had an impact on the odds ratios for the different CRP levels. Cox regression analysis was used to compare new-onset AF and death during the first 2 weeks after hospitalization. Results: A total of 672 patient charts were studied; 104 patients (15.4%) had new-onset AF. Peak incidence of new-onset AF occurred on the day of admission. Peak CRP values were reached during the following 2 days. High CRP level at admission did not predict the occurrence of AF. The observed mortality was higher among patients with new-onset AF (p = 0.001) during the first 2 weeks after hospitalization, but this effect disappears when adjusted for relevant factors. Conclusions: The frequency of new-onset AF in bacteremia is substantial. Initial CRP levels or white blood cell count do not seem to predict new-onset AF, as opposed to systemic inflammatory response syndrome. On the other hand, in patients with bacteremia, new-onset AF should be viewed as an indicator of increased mortality and morbidity.

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A Multicenter Risk Index for Atrial Fibrillation After Cardiac Surgery

Cited by 1,073 publications

References 29 publications

Usefulness of HATCH score as a predictor of atrial fibrillation after coronary artery bypass graft

Usefulness of HATCH score as a predictor of atrial fibrillation after coronary artery bypass graft

Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis

New-Onset Atrial Fibrillation in Bacteremia Is Not Associated with C-Reactive Protein, but Is an Indicator of Increased Mortality during Hospitalization

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