Postoperative and nonoperative atrial fibrillation associated with similar risks of stroke and death

Reference

Siontis KC, Gersh BJ, Weston SA, et al. Associations of atrial fibrillation after noncardiac surgery with stroke, subsequent arrhythmia, and death. Ann Intern Med 2022;175(8):1065-1072.

Synopsis

Using medical record data from a community-based cohort of patients in Minnesota, these investigators identified adults with a first episode of atrial fibrillation (AF) between the years 2000 and 2013 and categorized them as either having postoperative AF (defined as having AF within 30 days of a noncardiac surgery) or as nonoperative AF (not associated with surgery). Of the 4231 patients identified, 13% had postoperative AF. Patients in both postoperative and nonoperative groups had a mean age of 72 years, 52% were men, and 97% were White. As compared with the nonoperative group, the postoperative group had a higher prevalence of comorbidities and a higher mean CHAD2DS2VASc score (3.6 vs 3.3). Fewer patients in the postoperative group were prescribed anticoagulants (50% vs 62%). Approximately 18% of patients in the postoperative group had a subsequent episode of AF at 1 year. In weighted analyses using propensity scoring, while the postoperative group had a 13.4% lower risk of subsequent AF than the nonoperative group, the risk of stroke or transient ischemic attack and the risk of death were similar. In adjusted analyses that also accounted for anticoagulant use, findings were similar.