Coronary disease & ACSMeta-analysis
Anticoagulation for post-operative atrial fibrillation after isolated coronary artery bypass grafting: a meta-analysis
- Systematic review and meta-analysis of non-randomised studies
Authors' conclusion
In multiple timeframes following CABG, the incidence of complications in patients who develop POAF is low. The use of OAC in patients with POAF after CABG is associated with increased bleeding risk.
Study context
- Population
- Patients with new-onset post-operative AF (post-operative atrial fibrillation (POAF)) after coronary artery bypass grafting (CABG)
- Participants
- 1,698,307 CABG patients
- Comparison
- Oral anticoagulation (OAC) vs no OAC for POAF after CABG
- Outcome
- Thromboembolic events, bleeding and mortality
Pooled result
As reported in the abstract
Thromboembolic events, mortality, bleeding (OAC users vs non-users)
Effect size
- thromboembolic risk; no significant difference
- −0.11 (CI −0.36 to 0.13)
- mortality; no significant difference
- −0.07 (CI −0.21 to 0.07)
- bleeding; higher with OAC
- 0.32 (CI 0.06–0.58)
Further pooled results
| Outcome | Values |
|---|---|
| 30-day outcomes, POAF vs non-POAF | POAF Thromboembolic events 0.3% · Mortality 1.0% · Bleeding 1.1% · Non-POAF Thromboembolic events 0.8% · Mortality 0.5% · Bleeding 2.7% |
| Long-term outcomes per 100 person-years, POAF vs non-POAF · median 4.6 years | POAF Thromboembolic events 1.73 · Mortality 3.39 · Bleeding 2.00 · Non-POAF Thromboembolic events 1.14 · Mortality 2.19 · Bleeding 1.60 |
- 30-day outcomes, POAF vs non-POAF — Overall thromboembolic events
- 1.0%
- 30-day outcomes, POAF vs non-POAF — Overall mortality
- 2.0%
POAF incidence and OAC use
- POAF incidence range
- 7.9% to 37.6%
- POAF patients receiving OAC
- 15.5%
Safety
| Outcome | effect size (CI) |
|---|---|
| Bleeding risk with OAC · higher bleeding risk with OAC | 0.32 (0.06–0.58) |
Original publication
Anticoagulation for post-operative atrial fibrillation after isolated coronary artery bypass grafting: a meta-analysis. Eur Heart J. Published 29 May 2024. doi:10.1093/eurheartj/ehae267
Summarised from the published abstract; every number is checked against it