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Prognostic value of paroxysmal atrial fibrillation, first appearing after coronary artery bypass grafting: results of a 2-year follow-up

Authors: Sokolova N.Yu., Savelyeva E.A., Martynova K.A., Makhau-ri A.D., Medzhidov S.R.

Company: Tver State Medical University, Tver, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2024-18-1-73-82

For citation: Sokolova N.Yu., Savelyeva E.A., Martynova K.A., Makhauri A.D., Medzhidov S.R. Prognostic value of paroxysmal atrial fibrillation, first appearing after coronary artery bypass grafting: results of a 2-year follow-up. Creative Cardiology. 2024; 18 (1): 73–82 (in Russ.). DOI: 10.24022/1997-3187-2024-18-1-73-82

Received / Accepted:  12.01.2024 / 19.02.2024

Keywords: chronic ischemic heart disease coronary artery bypass grafting postoperative atrial fibrillation longterm results of coronary artery bypass grafting



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Abstract

Objective. To study the effect of new-onset atrial fibrillation (AF) after coronary artery bypass grafting (CABG) on the incidence of adverse cardiovascular outcomes over a 2-year postoperative follow-up period.

Material and methods. A single-center, prospective, observational, non-randomized study included 152 patients with chronic ischemic heart disease. The average age of the patients was 64.4±5.9 years. All patients after CABG were divided into 2 groups depending on the occurrence of AF in the early postoperative period: group 1 with postoperative AF (POAF) – n=43 (28.3%), group 2 without POAF – n=109 (71.7%). The end points of the study were all-cause mortality, cardiac and non-cardiac mortality, the development of non-fatal myocardial infarction (MI) and non-fatal stroke, recurrence of AF after CABG, the composite point was the development of “major” adverse cardiovascular complications.

Results. In the long-term period, we observed 138 of 152 initially included patients: in the group with POAF – 38 and without POAF – 100 patients. The average follow-up period was 24.2±3 months. The occurrence of non-fatal ischemic stroke: in the POAF group – 5 (13.2%), without POAF – 4 (4.0%), p=0.065. Relapses/new cases of AF: 16 (42.1%) versus 6 (6.0%), respectively, in the POAF and without POAF groups, p<0.001. All-cause mortality: 8 (21.1%) vs. 9 (9.0%), respectively, in the POAF and no-POAF groups, p=0.055. Mortality from noncardiac causes: 6 (15.7%) versus 5 (5.0%), respectively, in the POAF and without POAF groups, p=0.046; cardiac mortality: 2 (5.2%) versus 4 (4.0%), respectively, in the POAF and without POAF groups, p=0.53. Incidence of nonfatal myocardial infarction: 3 (7.9%) vs. 3 (3.0%), respectively, in the POAF and non-POAF groups, p=0.217. Development of “major” adverse cardiovascular events (cardiac mortality, non-fatal stroke and non-fatal MI): 10 (26.3%) versus 11 (11.0%), respectively, in the POAF and without POAF groups, p=0.028.

Conclusion. Patients with POAF have a high risk of recurrent AF in the long term after CABG. There was no effect of paroxysmal POAF on overall and cardiac mortality, or on the development of non-fatal stroke and heart attack, but an increase in the proportion of “major” adverse cardiovascular complications was detected in patients after CABG with paroxysmal POAF in a long-term 2-year period.

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About Authors

  • Natalya Yu. Sokolova, Dr. Med. Sci., Cardiologist; ORCID
  • Ekaterina A. Savelyeva, Cardiologist; ORCID
  • Kseniya A. Martynova, Cardiologist; ORCID
  • Anzor D. Makhauri, Endovascular Surgeon; ORCID
  • Sabir R. Medzhidov, Cardiovascular Surgeon; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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