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Atrial Fibrillation Tied to Worse Noncardiac Surgery Outcomes

Findings seen for older adults across sex, race, surgery type, and cardiac risk levels

TUESDAY, June 21, 2022 (HealthDay News) — Preexisting atrial fibrillation (AF) is independently associated with adverse postoperative outcomes following noncardiac surgery in older adults, according to a study published in the June 28 issue of the Journal of the American College of Cardiology.

Sameer Prasada, M.D., from the Cleveland Clinic, and colleagues assessed the impact of AF on the risk for adverse outcomes after noncardiac surgery. The analysis included a national sample of 8.6 million Medicare beneficiaries who underwent noncardiac surgery (vascular, thoracic, general, genitourinary, gynecological, orthopedics and neurosurgery, breast, head and neck, and transplant) between 2015 and 2019 (16.4 percent with AF).

The researchers found that in a propensity-matched analysis, AF was associated with a higher risk for mortality (odds ratio, 1.31), heart failure (odds ratio, 1.31), and stroke (odds ratio, 1.40), as well as a lower risk for myocardial infarction (odds ratio, 0.81). In a subgroup analysis by sex, race, type of surgery, and all strata of the revised cardiac risk index and CHA2DS2-VASc score, results were similar. The discriminative ability of the revised cardiac risk index was improved with the addition of AF.

“Our findings call for incorporating AF as a risk factor in perioperative risk scores for cardiovascular morbidity and mortality,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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