Arrhythmias & electrophysiology
New-onset atrial fibrillation after coronary surgery and stroke risk: a nationwide cohort study
Authors' conclusion
Prior ischaemic stroke, advancing age, history of heart failure and myocardial infarction were associated with 1-year ischaemic stroke risk in patients with POAF after CABG. CHA2DS2-VASc and ATRIA scores predicted stroke risk with similar accuracy as in non-surgical atrial fibrillation cohorts. OAC dispense at discharge does not seem to reflect individual stroke risk.
Study context
- Population
- First-time isolated coronary artery bypass grafting (CABG) patients with new-onset postoperative atrial fibrillation (POAF), Sweden, 2007–20206,903 without oral anticoagulation (OAC)
- Participants
- 10,435 participants
- Outcome
- Ischaemic stroke (predictors, in patients without OAC)
- Follow-up
- 1 year
Methodological detailsprospectively collected registry data, 4 mandatory Swedish national registries
- Prospectively collected registry data
- 4 mandatory Swedish national registries
Main finding
As reported in the abstract
Ischaemic stroke, patients without OAC
- Ischaemic stroke within 1 year (no OAC)
- 3.1%
- Advancing age, aOR per 10-year increase
- 1.86 (95% CI 1.45 to 2.38)
- Prior ischaemic stroke at 60 years, aOR
- 18.56 (95% CI 10.05 to 34.28)
- Prior ischaemic stroke at 80 years, aOR
- 5.95 (95% CI 3.78 to 9.37)
- MI, aOR
- 1.55 (95% CI 1.14 to 2.10)
- HF, aOR
- 1.53 (95% CI 1.06 to 2.21)
Observational data: associations, not effects.
Further findings
| Outcome | CHA2DS2-VASc | ATRIA | P value |
|---|---|---|---|
| Predictive ability for ischaemic stroke (AUC), patients without OAC | P = 0.021 | ||
| AUC | 0.72 (0.69-0.76) | 0.74 (0.70-0.78) |
OAC at discharge, CHA2DS2-VASc stroke risk >2%/year
- Not discharged on OAC
- 71.0%
Original publication
New-onset atrial fibrillation after coronary surgery and stroke risk: a nationwide cohort study. Heart. Published 4 October 2024. doi:10.
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