New-onset Afib tied to increased risk for stroke and mortality

  • Lin MH & al.
  • Stroke
  • 2 May 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This meta-analysis suggests that patients with new-onset perioperative/postoperative atrial fibrillation (POAF) are at an increased risk for stroke and mortality, both in the short-and long-term compared with those without POAF.

Why this matters

  • Findings highlight the need for a strategy to reduce stroke risk among patients with POAF.

Study design

  • 35 studies involving 2,458,010 participants met eligibility criteria after a search on PubMed, EMBASE and Cochrane Library.
  • Funding: Ministry of Science and Technology, Taiwan.

Key results

  • POAF was associated with increased risks for:
    • early stroke (OR, 1.62; 95% CI, 1.47-1.80; P<.00001>
    • early mortality (OR, 1.44; 95% CI, 1.11-1.88; P=.007),
    • long-term stroke (HR, 1.37; 95% CI, 1.07-1.77; P=.01) and
    • long-term mortality (HR, 1.37; 95% CI, 1.27-1.49; P<.00001>
  • In subgroup analyses, POAF was associated with higher risk for stroke in patients receiving noncardiac surgery vs cardiac surgery (HR, 2.00; 95% CI, 1.70-2.35 vs HR, 1.20; 95% CI, 1.07-1.34; P for subgroup difference <.0001>

Limitations

  • Heterogeneity among included studies.

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