Abstract 12010: Duration of Postoperative Atrial Fibrillation After Coronary Artery Bypass Graft Surgery is Associated With Poor Perioperative Outcomes

Background: Postoperative atrial fibrillation (POAF) is one of the most common complications after coronary artery bypass graft surgery (CABG). It has long been associated with poor perioperative outcomes, but few studies have been carried out regarding the effect of POAF duration on those outcomes.

Research Questions: Does prolonged duration of POAF have an adverse effect on perioperative outcomes of CABG?

Methods: This retrospective cohort study examined CABG patients enrolled at Beijing Anzhen Hospital from January 2018 to September 2021. We compared POAF duration ≥48 hours patients with POAF duration <48 hours patients. Primary outcomes examined were in-hospital mortality, stroke, acute respiratory failure (ARF), acute kidney injury (AKI), as well as significant gastrointestinal bleeding (GIB); secondary outcomes were postoperative length of stay (LOS), intensive care unit (ICU) stay. Associations between primary outcomes and POAF duration were determined using logistic regression and restricted cubic spline analyses.

Results: Out of 11 848 CABG patients, 3604 (30.4%) had POAF; 1131 (31.4%) of POAF patients had it for duration ≥48 hours. ARF (adjusted odds ratio [OR]: 2.96, 95% confidence interval [CI]: 1.47 - 6.09), AKI (adjusted OR: 2.37, 95% CI: 1.42 - 3.99), and significant GIB (adjusted OR: 2.60, 95% CI: 1.38 - 5.03), but not in-hospital mortality (adjusted OR: 1.56, 95% CI: 0.92 - 2.65) or stroke (adjusted OR: 1.29, 95% CI: 0.70 - 2.33) was associated with POAF duration ≥48 hours. These findings were still applicable, even after conducting propensity score matching and inverse probability of treatment weighting analyses.

Conclusions: POAF duration longer than 48 hours was independently associated with poorer perioperative recovery from CABG, with respect to the occurance of AFR, AKI and GIB, as well as longer postoperative LOS and ICU stay. However, it was not associated with greater in-hospital mortality or stroke occurrence. All these findings suggest that postoperative monitoring of POAF and positive intervention after detection could optimize post-CABG patient outcomes.