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

 Seung-Hyun Lee  ;  Hancheol Lee  ;  Jin-Kyu Park  ;  Jae-Sun Uhm  ;  Jong-Youn Kim  ;  Hui-Nam Pak  ;  Moon-Hyoung Lee  ;  Ho-Geun Yoon  ;  Boyoung Joung 
 YONSEI MEDICAL JOURNAL, Vol.58(6) : 1119-1127, 2017 
Journal Title
Issue Date
Aged ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/etiology* ; Atrial Fibrillation/mortality ; Coronary Artery Bypass/adverse effects* ; Coronary Artery Bypass/mortality ; Coronary Artery Disease/surgery* ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications/epidemiology* ; Postoperative Period ; Propensity Score ; Proportional Hazards Models ; Republic of Korea ; Retrospective Studies ; Sex Factors ; Survival ; Time Factors
Atrial fibrillation ; coronary artery bypass graft ; gender ; postoperative complications ; survival
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 significant predictor 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 patients with POAF.
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1. College of Medicine (의과대학) > Dept. of Biochemistry and Molecular Biology (생화학-분자생물학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Yoon, Ho Geun(윤호근) ORCID logo https://orcid.org/0000-0003-2718-3372
Lee, Moon-Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Lee, Seung Hyun(이승현) ORCID logo https://orcid.org/0000-0001-7549-9430
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
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