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dc.contributor.authorMegens, MR
dc.contributor.authorChurilov, L
dc.contributor.authorThijs, V
dc.date.accessioned2020-12-18T02:54:04Z
dc.date.available2020-12-18T02:54:04Z
dc.date.issued2017-12-01
dc.identifierpii: JAHA.117.007558
dc.identifier.citationMegens, M. R., Churilov, L. & Thijs, V. (2017). New-Onset Atrial Fibrillation After Coronary Artery Bypass Graft and Long-Term Risk of Stroke: A Meta-Analysis. JOURNAL OF THE AMERICAN HEART ASSOCIATION, 6 (12), https://doi.org/10.1161/JAHA.117.007558.
dc.identifier.issn2047-9980
dc.identifier.urihttp://hdl.handle.net/11343/255546
dc.description.abstractBACKGROUND: New-onset atrial fibrillation (NOAF) after coronary artery bypass graft is related to an increased short-term risk of stroke and mortality. We investigated whether the long-term risk of stroke is increased. METHODS AND RESULTS: We performed a systematic review and meta-analysis of studies that included patients who had coronary artery bypass graft and who afterwards developed NOAF during their index admission; these patients did not have previous atrial fibrillation. The primary outcome was risk of stroke at 6 months or more in patients who developed NOAF compared with those who did not. Odds ratios, relative risk, and hazard ratios were considered equivalent; outcomes were pooled on the log-ratio scale using a random-effects model and reported as exponentiated effect-sizes. We included 16 studies, comprising 108 711 participants with a median follow-up period of 2.05 years. Average participant age was 66.8 years, with studies including an average of 74.8% males. There was an increased long-term risk of stroke in the presence of NOAF (unadjusted studies effect-sizes=1.36, 95% confidence interval, 1.12-1.65, P=0.001, adjusted studies effect-sizes=1.25, 95% confidence interval, 1.09-1.42, P=0.001). There was evidence of moderate effect variation because of heterogeneity in studies reporting unadjusted (P=0.021, I2=49.8%) and adjusted data (P=0.081, I2=49.1%), and publication bias in the latter group (Egger's test, P=0.031). Sensitivity analysis on unadjusted data by study quality, design, and surgery did not alter the effect direction. CONCLUSIONS: Presence of NOAF in patients post-coronary artery bypass graft is associated with increased long-term risk of stroke compared with patients without NOAF. Further studies may show whether the increased risk is mediated by atrial fibrillation and whether anticoagulation reduces risk.
dc.languageEnglish
dc.publisherWILEY
dc.titleNew-Onset Atrial Fibrillation After Coronary Artery Bypass Graft and Long-Term Risk of Stroke: A Meta-Analysis
dc.typeJournal Article
dc.identifier.doi10.1161/JAHA.117.007558
melbourne.affiliation.departmentMedicine and Radiology
melbourne.affiliation.departmentFlorey Department of Neuroscience and Mental Health
melbourne.source.titleJournal of the American Heart Association
melbourne.source.volume6
melbourne.source.issue12
dc.rights.licenseCC BY-NC-ND
melbourne.elementsid1287737
melbourne.contributor.authorChurilov, Leonid
melbourne.contributor.authorThijs, Vincent
dc.identifier.eissn2047-9980
melbourne.accessrightsOpen Access


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