Long-Term Effects of Postoperative Atrial Fibrillation following Mitral Valve Surgery

Alghosoon, Haneen; Arafat, Amr A.; Albabtain, Monirah A; Alsubaie, Faisal F.; Alangari, Abdulaziz S.

doi:10.3390/jcdd10070302

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…This type of arrhythmia can develop following different types of cardiac surgeries, including coronary artery bypass grafting (CABG), valve repair or replacement, and congenital heart defect repair (5). POAF development has been associated with several adverse consequences, including increased risks of hemodynamic instability, stroke, heart failure, infections, thromboembolic events, renal failure, reduced quality of life, extended hospital stays, and short-and long-term mortality (2,(6)(7)(8)(9). Identifying patients at the highest risk for developing POAF could allow for more targeted prophylactic therapy and management to improve outcomes.…”

Section: Introductionmentioning

confidence: 99%

Systemic immune–inflammation index for predicting postoperative atrial fibrillation following cardiac surgery: a meta-analysis

Chen,

Liu,

Hsu

et al. 2024

Front. Cardiovasc. Med.

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BackgroundPostoperative atrial fibrillation (POAF) is a frequent complication that may increase morbidity and mortality risk following cardiac surgery. The systemic immune–inflammation index (SII) is an emerging biomarker that provides an integrated measure of inflammation by incorporating neutrophil, lymphocyte, and platelet counts. Recent studies have reported associations between elevated SII and increased POAF risk; however, significant heterogeneity exists regarding its predictive efficacy. This meta-analysis aimed to assess SII's diagnostic efficacy for predicting POAF risk.MethodsTo synthesize existing evidence on the ability of perioperative SII for predicting POAF in patients undergoing cardiac surgery, a systematic review and meta-analysis was conducted. In August 2023, a comprehensive literature search was performed to identify relevant studies reporting SII cutoff values with corresponding sensitivity and specificity. The primary aim was to evaluate SII's diagnostic utility for predicting POAF, whereas secondary outcomes included the pooled incidence of POAF and the relationship between the SII and POAF.ResultsEight studies published between 2021 and 2023 with 3,245 patients were included. Six studies involved coronary artery bypass grafting (CABG) surgery; one encompassed various cardiac procedures, and another focused solely on mitral valve surgery. The pooled incidence of POAF was 23.6% [95% confidence interval (CI), 18.7%–29.2%]. Elevated SII significantly increased the odds of POAF by 3.24-fold (odds ratio, 3.24; 95% CI, 1.6–6.55; p = 0.001). SII's pooled sensitivity and specificity for predicting POAF were 0.80 (95% CI, 0.68–0.89) and 0.53 (95% CI, 0.23–0.8), respectively. The SII had moderate predictive accuracy based on a hierarchical summary receiver operating characteristic (HSROC) area under the curve of 0.78 (95% CI, 0.74–0.81). Subgroup analyses, whether focusing on CABG alone or CABG with cardiopulmonary bypass (CPB), both indicated an area under the HSROC curve of 0.78 (95% CI, 0.74–0.81).ConclusionElevated SII is significantly correlated with an increased POAF risk following cardiac surgery, highlighting its utility as a predictive biomarker. Considering its moderate diagnostic accuracy, further research is essential for clarifying SII's clinical effectiveness, either as an independent predictor or combined with other risk factors, for stratifying patients at high POAF risk.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier [CRD42023456128].

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Section: Introductionmentioning

confidence: 99%

Systemic immune–inflammation index for predicting postoperative atrial fibrillation following cardiac surgery: a meta-analysis

Chen,

Liu,

Hsu

et al. 2024

Front. Cardiovasc. Med.

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Effect of Postoperative Atrial Fibrillation After Cardiac Surgery: A Meta‐Analysis

Qu,

Yang,

et al. 2024

Clinical Cardiology

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BackgroundA meta‐analysis study was conducted to determine how to predict the effect of postoperative atrial fibrillation after cardiac surgery.HypothesisLong‐term mortality and cardiovascular morbidity are linked to postoperative atrial fibrillation.MethodUntil August 2024, a comprehensive literature study was completed, and 3486 connected studies were revised. The 38 selected studies included 241 299 cardiac surgery participants at the beginning of the study. The odds ratio (OR) and 95% confidence intervals (CIs) were used to look at the effect of atrial fibrillation after heart surgery using two‐sided methods and either a fixed or random model.ResultsIndividuals with cardiac surgery with postoperative atrial fibrillation had significantly higher mortality at 1 year (OR, 1.39; 95% CI, 1.12–1.72, p < 0.001), mortality at 5 years (OR, 1.61; 95% CI, 1.33–1.94, p < 0.001), mortality at 10 years (OR, 1.61; 95% CI, 1.39–1.87, p < 0.001), and overall stroke (OR, 1.61; 95% CI, 1.34–1.94, p < 0.001) compared to without postoperative atrial fibrillation.ConclusionsIndividuals with cardiac surgery with postoperative atrial fibrillation had significantly higher mortality at 1 year, mortality at 5 years, mortality at 10 years, and overall stroke compared to those without postoperative atrial fibrillation. To validate this discovery, more research and caution must be implemented when interacting with its values.

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Scores predicting atrial fibrillation after mitral valve surgery: Do we need a more specific score?

Albabtain,

Almathami,

Alghosoon

et al. 2024

Journal of Arrhythmia

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BackgroundAtrial fibrillation after cardiac surgery (POAF) is associated with increased morbidity and mortality. Several scores were used to predict POAF, with variable results. Thus, this study assessed the performance of several scoring systems to predict POAF after mitral valve surgery. Additionally, we identified the risk factors for POAF in those patients.MethodsThis retrospective cohort included 1381 recruited from 2009 to 2021. The patients underwent mitral valve surgery, and POAF occurred in 233 (16.87%) patients. The performance of CHADS2, CHA2DS2‐VASc, POAF, EuroSCORE II, and HATCH scores was evaluated.ResultsThe median age was higher in patients who developed POAF (60 vs. 54 years; p < .001). CHA2‐DS2‐VASc, POAF, EuroSCORE II, and HATCH scores significantly predicted POAF, with areas under the curve of the receiver operator curve (AUCROC) of 0.56, 0.61, 0.58, and 0.54, respectively. We identified age > 58 years, body mass index > 28 kg/m2, creatinine clearance < 90 mL/min, reoperative surgery, and preoperative inotropic and intra‐aortic balloon pump use as predictors of POAF. We constructed a score from these variables (PSCC‐AF). A score > 2 significantly predicted POAF (p < .001). The AUCROC of this score was 0.67, which was significantly higher than the AUCROC of the POAF score (p = .009).ConclusionPOAF after mitral valve surgery can be predicted based on preoperative patient characteristics. The new PSCC‐AF score significantly predicted POAF after mitral valve surgery and can serve as a bedside diagnostic tool for POAF risk screening. Further studies are needed to validate the PSCC‐AF‐mitral score externally.

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Long-Term Effects of Postoperative Atrial Fibrillation following Mitral Valve Surgery

Cited by 3 publications

References 30 publications

Systemic immune–inflammation index for predicting postoperative atrial fibrillation following cardiac surgery: a meta-analysis

Systemic immune–inflammation index for predicting postoperative atrial fibrillation following cardiac surgery: a meta-analysis

Effect of Postoperative Atrial Fibrillation After Cardiac Surgery: A Meta‐Analysis

Scores predicting atrial fibrillation after mitral valve surgery: Do we need a more specific score?

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