Takeaway
- Blood transfusion (BT) in patients undergoing coronary artery bypass grafting (CABG) surgery was associated with a significantly increased risk for postoperative Afib.
Why this matters
- Pathophysiology of postoperative AF remains unclear; however recent studies support an inflammatory mechanism in the development of Afib.
- BT is believed to alter many inflammatory mediators and augment the inflammatory response.
Study design
- Meta-analysis of 8 cohort studies including 7401 cases with Afib and 31,069 participants.
- Study quality was assessed using the Newcastle–Ottawa scale.
- Funding: None disclosed.
Key results
- Risk of developing postoperative Afib was significantly higher in adult patients who underwent CABG surgery with BT (OR, 1.45; 95% CI, 1.26-1.67); significant heterogeneity across studies was observed (Pheterogeneity<.0001).
- After classifying patients based on surgery types, the risk for postoperative Afib was found to be similar between the patients who underwent CABG (OR, 1.59; 95% CI, 1.17-2.14) and CABG plus valve replacement (OR, 1.40; 95% CI, 1.17-1.69).
- After exclusion of studies that included off-pump CABG, no significant improvement in postoperative Afib risk was observed (OR, 1.36; 95% CI, 1.23-1.50).
Limitations
- Risk for bias.
- Red blood cells storage time, and the volume and rate of transfusion were not considered.
References
References
