Gender Difference in the Long-Term Clinical Implications of New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting

Abstract

Purpose: New-onset postoperative atrial fibrillation (POAF) is associated with poor short- and long-term outcomes after isolated coronary artery bypass graft (CABG) surgery. This study evaluated gender differences in the long-term clinical implications of POAF.

Materials and Methods: After propensity score matching, a gender-based comparison of long-term (>1 year) newly developed atrial fibrillation (LTAF) and mortality between 1664 (480 females) consecutive patients with (POAF) and without POAF (no-POAF) who had undergone CABG was performed.

Results: During a follow-up of 49±28 months, cumulative survival free of LTAF was lower in the POAF group than in the no-POAF group for both males (92.1% vs. 98.2%, p<0.001) and females (84.1% vs. 98.0%, p<0.001). However, female patients with POAF more frequently developed LTAF than male POAF patients (13.9 % vs. 6.9%, p=0.049). In multivariate analysis, POAF was a significantpredictor of LTAF among males [hazard ratio (HR) 4.91; 95% confidence interval (CI) 1.22−19.79, p=0.031] and females (HR 16.50; 95% CI 4.79−56.78; p<0.001). POAF was a predictor of long-term mortality among females (adjusted HR 3.96; 95% CI 1.13−13.87, p=0.033), but not among males.

Conclusion: Although POAF was related to LTAF in both genders, cumulative survival free of LTAF was poorer among females than among males. Additionally, a significant correlation with long-term mortality after CABG was observed among female patientswith POAF.