Arrhythmias & electrophysiology
Role of anticoagulation therapy in modifying stroke risk associated with new-onset atrial fibrillation after non-cardiac surgery
Main finding · Ischemic strokeResult — go to the resultAdjusted relative risk 1.60 95% CI 1.37–1.87Authors' conclusion
These findings suggest that POAF is predictable and associated with an increased risk of postoperative ischemic stroke in patients who do not receive postoperative anticoagulation.
Study context
- Population
- Adults undergoing non-cardiac surgical procedures
- Participants
- 251,837 adults2 sites
- Exposure
- New-onset postoperative atrial fibrillation (POAF) vs no POAF after non-cardiac surgery, by postoperative OAC
- POAFn = 4,538
- Outcome
- Ischemic stroke
- Follow-up
- 1 year
Methodological detailstwo sites
- Two sites
Main finding
As reported in the abstract
Adjusted relative risk
1.60
95% CI 1.37–1.87
P < 0.001
By group
POAFvs No POAF
adjusted RR 1.60 (95% CI 1.37–1.87); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Stroke attributable to POAF, by postoperative OAC (subgroup)POAFvs No POAFWithout OAC | RR 1.81 (95% CI 1.44–2.28) | P < 0.001 | |
| Stroke attributable to POAF, by postoperative OAC (subgroup)POAFvs No POAFWith OAC | adjusted RR 1.04 (95% CI 0.71–1.51) | P = 0.847 | |
| 0.512Ratio (log scale) |
- Stroke attributable to POAF, by postoperative OAC (subgroup): P for interaction = 0.013
Prediction model for POAF
- Model derived and validated for POAF prediction from demographics, comorbidities and procedural risk
Original publication
Role of anticoagulation therapy in modifying stroke risk associated with new-onset atrial fibrillation after non-cardiac surgery. Nat Med. Published 23 August 2024. doi:10.
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