Comparison of Risk of Atrial Fibrillation in Black Versus White Patients After Coronary Artery Bypass Grafting

Efird, Jimmy T.; Gudimella, Preeti; O’Neal, Wesley T.; Griffin, William F.; Landrine, Hope; Kindell, Linda C.; Davies, Stephen; Sarpong, Daniel F.; O’Neal, Jason B.; Crane, Patricia B.; Nelson, Margaret; Ferguson, T. Bruce; Chitwood, W. Randolph; Kypson, Alan P.; Anderson, Ethan J.

doi:10.1016/j.amjcard.2015.12.056

Cited by 9 publications

(8 citation statements)

References 26 publications

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“…Caucasian ethnicity has been found to be a predictor for POAF [5,7,36,37]. A study by Efird et al [37] of 13,594 patients undergoing first-time, isolated CABG found that POAF is significantly associated with white race (95% CI, p < 0.0001).…”

Section: Ethnicitymentioning

confidence: 99%

Determinants of atrial fibrillation after cardiac surgery

Qureshi¹,

Ahmed²,

Massie³

et al. 2021

Rev. Cardiovasc. Med.

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Post-operative Atrial fibrillation (POAF) is a common complication post cardiac surgery. It can result in detrimental short-and long-term outcomes due to the increased risk of stroke, cardiac arrest and congestive heart failure in addition to prolonged intensive care and total hospital stay raising the overall healthcare cost. Accurately identifying predictors and biomarkers for POAF ensures that patients at greatest risk can be given the appropriate prophylactic measures; resources can be distributed to the groups who are most in need and where they will gain the optimum effect. Commonly recurring predictors can be investigated further to unveil the pathophysiology behind POAF, which has yet to be fully understood. This literature review aims to examine relevant studies on the proposed predictors of POAF: increased age, gender, history of atrial fibrillation, hypertension, cardiopulmonary bypass time and the use of beta blockers amongst others. This paper will discuss the significance of both the well-known and newfound risk factors to consolidate the areas that require further exploration in order to highlight those at risk and to unravel the mechanism behind POAF.

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Section: Ethnicitymentioning

confidence: 99%

Determinants of atrial fibrillation after cardiac surgery

Qureshi¹,

Ahmed²,

Massie³

et al. 2021

Rev. Cardiovasc. Med.

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“…We further performed a subgroup analysis by type of cardiac operation. Seventeen articles [13-16, 18, 24, 25, 28, 29, 34, 35, 39, 42] reported the association in coronary artery bypass graft (CABG), two articles [19, 36] reported the association in valve surgery, and seven articles [9-13, 30, 31] reported the association in combined types of cardiac surgery. The summary RRs for a 5-unit increment in BMI in the CABG group, valve surgery group, and combined cardiac surgery group were 1.216 (95% CI: 1.21-1.219, I 2 =80%), 1.34 (95% CI: 0.81-2.22, I 2 =84%), and 1.13 (95% CI: 1.06-1.20, I 2 =79%), respectively (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Dose-response relationship among body mass index, abdominal adiposity and atrial fibrillation in patients undergoing cardiac surgery: a meta-analysis of 30 prospective studies

liu

Mei²,

et al. 2020

Preprint

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Background: Whether being overweight increases the risk of postoperative atrial fibrillation (POAF) is unclear, and whether adiposity independently contributes to POAF has not been comprehensively studied. Thus, we conducted a meta-analysis to clarify the strength and shape of the exposure-effect relationship between adiposity and POAF. Methods: The PubMed, Cochrane Library, and EMBASE databases were searched for prospective studies (RCTs, cohort studies, and nest-case control studies) reporting data regarding the relationship between adiposity and the risk of POAF. Results: Thirty publications involving 139,302 patients were included. Analysis of categorical variables showed that obesity (RR: 1.39, P<0.001), but not being underweight (RR: 1.44, P=0.13) or being overweight (RR: 1.03, P=0.48), was associated with an increased risk of POAF. In the exposure-effect analysis, the summary RR for a 5-unit increment in body mass index (BMI) was 1.09 (P<0.001) for the risk of POAF. There was a significant linear relationship between BMI and POAF (Pnonlinearity=0.91); the curve was flat and began to rise steeply at a BMI of approximately 30. Notably, BMI levels below 30 (overweight) were not associated with a higher risk of POAF. In the subgroup analysis of surgery types, the pooled RR values for a BMI increase of 5 for coronary artery bypass graft and valve surgery were 1.21 (P<0.01) and 1.34 (P=0.25), respectively, suggesting that a potential difference in the association exists by surgery type. Additionally, waist obesity was associated with the risk of POAF (RR: 1.55, P<0.001). Conclusion: Based on the current evidence, our findings show that adiposity was independently associated with an increased risk of POAF, while being underweight or overweight might not significantly increase the POAF risk. The magnitude of the effect of obesity on AF in patients undergoing valve surgery might be small, and this finding needs to be further confirmed.

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“…Thirty-three (34 cohorts) studies (Alam et al, 2011;Banach et al, 2007;Bidar et al, 2014;Bramer et al, 2011;Brandt et al, 2001;Echahidi et al, 2007;Efird et al, 2016;El-Chami et al, 2012;Engelman et al, 1999;Erdil et al, 2014;Gao et al, 2016;Ghanta et al, 2017;Girerd et al, 2009;Gurbuz et al, 2014;Hakala et al, 2009;Ivanovic et al, 2014;Kitahara et al, 2017;Kuduvalli et al, 2002;Lee & Jang, 2020;Melduni et al, 2011;Moulton et al, 1996;Omer et al, 2016;Pan et al, 2006;Perrier et al, 2017;Reeves et al, 2003;Stamou et al, 2011;Stefano et al, 2020;Sun et al, 2011;Tadic, Ivanovic & Zivkovic, 2011 Wong et al, 2015b;Yap et al, 2007;Zacharias et al, 2005) involving 33,271 cases/141,442 patients were included in the dose-response analysis of BMI and POAF. The summary RR for a 5-unit increase in BMI was 1.09 (95% CI [1.06-1.12]) with each weight not exceeding 7%.…”

Section: Dose-response Analysis Of the Effect Of Bmi On Poafmentioning

confidence: 99%

Dose-response relationship among body mass index, abdominal adiposity and atrial fibrillation in patients undergoing cardiac surgery: a meta-analysis of 35 cohorts

Liu

Mei

Xie

et al. 2021

PeerJ

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Background Whether overweight increases the risk of postoperative atrial fibrillation (POAF) is unclear, and whether adiposity independently contributes to POAF has not been comprehensively studied. Thus, we conducted a meta-analysis to clarify the strength and shape of the exposure-effect relationship between adiposity and POAF. Methods The PubMed, Cochrane Library, and EMBASE databases were searched for revelant studies (randomized controlled trials (RCTs), cohort studies, and nest-case control studies) reporting data regarding the relationship between adiposity and the risk of POAF. Results Thirty-five publications involving 33,271 cases/141,442 patients were included. Analysis of categorical variables showed that obesity (RR: 1.39, 95% CI [1.21–1.61]; P < 0.001), but not being underweight (RR: 1.44, 95% CI [0.90–2.30]; P = 0.13) or being overweight (RR: 1.03, 95% CI [0.95–1.11]; P = 0.48) was associated with an increased risk of POAF. In the exposure-effect analysis (BMI) was 1.09 (95% CI [1.05–1.12]; P < 0.001) for the risk of POAF. There was a significant linear relationship between BMI and POAF (Pnonlinearity = 0.44); the curve was flat and began to rise steeply at a BMI of approximately 30. Notably, BMI levels below 30 (overweight) were not associated with a higher risk of POAF. Additionally, waist obesity or visceral adiposity index was associated with the risk of POAF. Conclusion Based on the current evidence, our findings showed that high body mass index or abdominal adiposity was independently associated with an increased risk of POAF, while underweight or overweight might not significantly increase the POAF risk.

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Comparison of Risk of Atrial Fibrillation in Black Versus White Patients After Coronary Artery Bypass Grafting

Cited by 9 publications

References 26 publications

Determinants of atrial fibrillation after cardiac surgery

Determinants of atrial fibrillation after cardiac surgery

Dose-response relationship among body mass index, abdominal adiposity and atrial fibrillation in patients undergoing cardiac surgery: a meta-analysis of 30 prospective studies

Dose-response relationship among body mass index, abdominal adiposity and atrial fibrillation in patients undergoing cardiac surgery: a meta-analysis of 35 cohorts

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