Impact of atrial fibrillation on the risk of major adverse cardiac events following coronary revascularisation
Objective Atrial fibrillation (AF) remains a highly prevalent arrhythmia with significant burden on morbidity and mortality. The impact of AF in the revascularised population remains incompletely described. Given the high prevalence of AF in the revascularised population, we sought to evaluate the i...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-08-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/9/2/e002012.full |
| _version_ | 1827900212476116992 |
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| author | Vincent Chan Taylor Gillmore Simon Parlow Hadi Toeg Cheng Yee Goh Pietro Di Santo Trevor Simard Louis Verreault-Julien Benjamin Hibbert Richard G Jung Omar Abdel-Razek Cameron Stotts Dwipen Makwana Joelle Soriano Robert Moreland Caleb Sypkes Daniel F Ramirez Mouhannad Sadek Michael P V Froeschl Marino Labinaz |
| author_facet | Vincent Chan Taylor Gillmore Simon Parlow Hadi Toeg Cheng Yee Goh Pietro Di Santo Trevor Simard Louis Verreault-Julien Benjamin Hibbert Richard G Jung Omar Abdel-Razek Cameron Stotts Dwipen Makwana Joelle Soriano Robert Moreland Caleb Sypkes Daniel F Ramirez Mouhannad Sadek Michael P V Froeschl Marino Labinaz |
| author_sort | Vincent Chan |
| collection | DOAJ |
| description | Objective Atrial fibrillation (AF) remains a highly prevalent arrhythmia with significant burden on morbidity and mortality. The impact of AF in the revascularised population remains incompletely described. Given the high prevalence of AF in the revascularised population, we sought to evaluate the incidence and prognosis in patients with pre-existing and new-onset AF following revascularisation.Methods We used the University of Ottawa Heart Institute Revascularisation Registry to identify patients who underwent revascularisation between August 2015 and March 2020, who were prospectively followed for an average of one year. We conducted a retrospective cohort study analysing the association between AF and clinical outcomes. The primary outcome of interest was 1-year major adverse cardiac events (MACE) defined as a composite of death, myocardial infarction, unplanned revascularisation and cerebrovascular accidents. Moreover, secondary outcomes include the individual components of MACE and bleeding.Results A total of 6704 patients underwent revascularisation and completed 1-year clinical follow-up. Median time to follow-up was 12.8 (IQR 11.2–15.9) months. One-year MACE occurred in 166 (21.8%) and 683 (11.5%) patients in AF and non-AF groups, respectively (adjusted HR, 1.61; 95% CI 1.29 to 2.01; p<0.0001). AF was independently predictive of 1-year mortality, myocardial infarction, unplanned revascularisation, cerebrovascular accident and bleeding. Within 1 year, 299 (4.5%) episodes of new-onset AF was observed. New-onset AF following revascularisation was also associated with 1-year MACE, mortality, myocardial infarction, cerebrovascular accident and unplanned revascularisation.Conclusions Preprocedural and new-onset AF following revascularisation remains highly predictive 1-year MACE. AF should be considered in addition to traditional risk factors for adverse outcomes following revascularisation. |
| first_indexed | 2024-03-12T23:27:54Z |
| format | Article |
| id | doaj.art-31249d4002064845b794d0b53bcc0602 |
| institution | Directory Open Access Journal |
| issn | 2053-3624 |
| language | English |
| last_indexed | 2024-03-12T23:27:54Z |
| publishDate | 2022-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj.art-31249d4002064845b794d0b53bcc06022023-07-16T00:00:07ZengBMJ Publishing GroupOpen Heart2053-36242022-08-019210.1136/openhrt-2022-002012Impact of atrial fibrillation on the risk of major adverse cardiac events following coronary revascularisationVincent Chan0Taylor Gillmore1Simon Parlow2Hadi Toeg3Cheng Yee Goh4Pietro Di Santo5Trevor Simard6Louis Verreault-Julien7Benjamin Hibbert8Richard G Jung9Omar Abdel-Razek10Cameron Stotts11Dwipen Makwana12Joelle Soriano13Robert Moreland14Caleb Sypkes15Daniel F Ramirez16Mouhannad Sadek17Michael P V Froeschl18Marino Labinaz19Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaUniversity of Ottawa, Ottawa, Ontario, CanadaDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaDepartment of Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaUniversity of Ottawa Heart Institute, Ottawa, Ontario, CanadaDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaCardiology, Mayo Clinic, Rochester, Minnesota, USADepartment of Cardiology, Emory University, Atlanta, Georgia, USADepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaUniversity of Ottawa, Ottawa, Ontario, CanadaUniversity of Ottawa, Ottawa, Ontario, CanadaUniversity of Ottawa, Ottawa, Ontario, CanadaUniversity of Ottawa Heart Institute, Ottawa, Ontario, CanadaUniversity of Ottawa, Ottawa, Ontario, CanadaDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaDepartment of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, CanadaObjective Atrial fibrillation (AF) remains a highly prevalent arrhythmia with significant burden on morbidity and mortality. The impact of AF in the revascularised population remains incompletely described. Given the high prevalence of AF in the revascularised population, we sought to evaluate the incidence and prognosis in patients with pre-existing and new-onset AF following revascularisation.Methods We used the University of Ottawa Heart Institute Revascularisation Registry to identify patients who underwent revascularisation between August 2015 and March 2020, who were prospectively followed for an average of one year. We conducted a retrospective cohort study analysing the association between AF and clinical outcomes. The primary outcome of interest was 1-year major adverse cardiac events (MACE) defined as a composite of death, myocardial infarction, unplanned revascularisation and cerebrovascular accidents. Moreover, secondary outcomes include the individual components of MACE and bleeding.Results A total of 6704 patients underwent revascularisation and completed 1-year clinical follow-up. Median time to follow-up was 12.8 (IQR 11.2–15.9) months. One-year MACE occurred in 166 (21.8%) and 683 (11.5%) patients in AF and non-AF groups, respectively (adjusted HR, 1.61; 95% CI 1.29 to 2.01; p<0.0001). AF was independently predictive of 1-year mortality, myocardial infarction, unplanned revascularisation, cerebrovascular accident and bleeding. Within 1 year, 299 (4.5%) episodes of new-onset AF was observed. New-onset AF following revascularisation was also associated with 1-year MACE, mortality, myocardial infarction, cerebrovascular accident and unplanned revascularisation.Conclusions Preprocedural and new-onset AF following revascularisation remains highly predictive 1-year MACE. AF should be considered in addition to traditional risk factors for adverse outcomes following revascularisation.https://openheart.bmj.com/content/9/2/e002012.full |
| spellingShingle | Vincent Chan Taylor Gillmore Simon Parlow Hadi Toeg Cheng Yee Goh Pietro Di Santo Trevor Simard Louis Verreault-Julien Benjamin Hibbert Richard G Jung Omar Abdel-Razek Cameron Stotts Dwipen Makwana Joelle Soriano Robert Moreland Caleb Sypkes Daniel F Ramirez Mouhannad Sadek Michael P V Froeschl Marino Labinaz Impact of atrial fibrillation on the risk of major adverse cardiac events following coronary revascularisation Open Heart |
| title | Impact of atrial fibrillation on the risk of major adverse cardiac events following coronary revascularisation |
| title_full | Impact of atrial fibrillation on the risk of major adverse cardiac events following coronary revascularisation |
| title_fullStr | Impact of atrial fibrillation on the risk of major adverse cardiac events following coronary revascularisation |
| title_full_unstemmed | Impact of atrial fibrillation on the risk of major adverse cardiac events following coronary revascularisation |
| title_short | Impact of atrial fibrillation on the risk of major adverse cardiac events following coronary revascularisation |
| title_sort | impact of atrial fibrillation on the risk of major adverse cardiac events following coronary revascularisation |
| url | https://openheart.bmj.com/content/9/2/e002012.full |
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