Arrhythmias & electrophysiologyCohort study
Role of anticoagulation therapy in modifying stroke risk associated with new-onset atrial fibrillation after non-cardiac surgery
- Cohort study
- two sites
Authors' 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 two sites
- Exposure
- Postoperative atrial fibrillation (POAF) vs No POAF
- POAFn = 4,538
- Outcome
- Ischemic stroke
- Follow-up
- 1 year
Main finding
As reported in the abstract
Adjusted relative risk
1.60
95% CI 1.37–1.87
P < 0.001
By group
POAF vs 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) — POAF vs No POAF · without OAC | RR 1.81 (95% CI 1.44–2.28) | P < 0.001 | |
| Stroke attributable to POAF, by postoperative OAC (subgroup) — POAF vs No POAF · with 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:10.1038/s41591-024-03206-0
Summarised from the published abstract; every number is checked against it