Short-term and Long-term Risk of Stroke in Patients With Perioperative Atrial Fibrillation After Cardiac Surgery: Systematic Review and Meta-analysis

Abstract

Short-term and long-term risk of stroke in patients with perioperative atrial fibrillation after cardiac surgery: Systematic review and meta-analysis, CJC Open (2021), doi:

Direct oral anticoagulants in atrial fibrillation following cardiac surgery: a systematic review and meta-analysis with trial sequential analysis

“…4 In a study investigating the effect of POAF in patients after cardiac surgery, long-term mortality rates in patients with post-cardiac surgical atrial fibrillation were reported to be significantly higher at 32.7%, 5 as compared with patients without post-cardiac surgical atrial fibrillation (22.4%). 5 Similarly, for patients who developed post-cardiac surgery atrial fibrillation, their incidence of experiencing major neurological events (MNEs) was 4.5%, 6 and the incidence of bleeding was 5%. 7 To counter the potentially disastrous sequelae of postcardiac surgical atrial fibrillation, anticoagulation therapy, primarily warfarin, is prescribed to the patient.…”

Use of Anticoagulation Therapy in Patients With Perioperative Atrial Fibrillation After Cardiac Surgery: A Systematic Review and Meta-analysis

“…Perioperative atrial fibrillation (POAF) is the most common arrhythmia encountered after cardiac surgery, with the estimated incidence of new-onset POAF ranging between 24% and 49%. 1 Although POAF has been viewed as a benign and self-limited phenomenon, a growing body of evidence suggests that POAF is associated with an increased short-term and long-term risk of stroke and death. [1][2][3] Oral anticoagulation therapy is highly effective for the long-term prevention of ischemic stroke and systemic embolism in patients with nonsurgical atrial fibrillation (AF).…”

“…1 Although POAF has been viewed as a benign and self-limited phenomenon, a growing body of evidence suggests that POAF is associated with an increased short-term and long-term risk of stroke and death. [1][2][3] Oral anticoagulation therapy is highly effective for the long-term prevention of ischemic stroke and systemic embolism in patients with nonsurgical atrial fibrillation (AF). 4 CJC Open -(2022) 1e8…”

“…Nous avons rapport e les risques relatifs (RR) sommaires d' etudes avec l'ajustement multivari e et l'estimation des diff erences du risque absolu avec des intervalles de However, the absolute risk of these events may be lower in patients with POAF. 1 The efficacy and safety of anticoagulation in patients with POAF after cardiac surgery are currently unclear. Moreover, given that the incidences of adverse outcomes after surgery change over time, the absolute risks and benefits of short-term and long-term use of anticoagulation therapy after POAF need to be considered separately.…”

Commentary: Sequelae of neurologic injury after cardiac surgery

“…Gaudino and colleagues 2 estimated a pooled rate of stroke after cardiac surgery of 2.0%, which increased the risk of operative mortality (21.3% vs 2.4%) and the incidence rate of late mortality (10.9% vs 3.4%) compared with those who did not experience stroke. Diseased ascending aorta, 3 carotid artery stenosis, 4 previous stroke, 2 complex cardiac surgery, 5 prolonged cardiopulmonary bypass, 6 postoperative atrial fibrillation, 7 and blood transfusion 8 are recognized as risk factors for stroke after cardiac surgery.…”