EFFECT OF RACE ON THE INCIDENCE OF ATRIAL FIBRILLATION POST-CORONARY ARTERY BYPASS SURGERY IN A MIDDLE EASTERN COMMUNITY IN THE UNITED STATES

Document Type

Conference Proceeding

Publication Date

3-7-2023

Publication Title

J Am Coll Cardiol

Abstract

Background Studies have shown a higher incidence of Atrial Fibrillation (AF) post coronary artery bypass surgery (CABG) in White patients. This retrospective cross-sectional study aims to characterize the incidence and risk factors for postoperative AF in Middle Eastern and Black patients compared to White patients. Methods Adult patients who underwent CABG between January 2014 and December 2021 were included. Baseline demographics and perioperative data were collected. Patients’ race designations were based on self-identification in the electronic health records. Univariate and multivariable analyses were conducted to identify predictors of postoperative AF. Results A total of 1686 patients were included (median age 67 years, 27% were females). There was a total of 1169 White, 440 Black, and 77 Middle Eastern patients. The overall incidence of postoperative AF was 40%. We observed a lower incidence of postoperative AF in Middle Eastern (32%, OR 0.59, 95% CI 0.36-0.97, P = 0.034) and Black patients (28%, OR 0.47, 95% CI 0.37-0.60, P = <0.001) as compared to White patients (45%). Other variables associated with postoperative AF on the univariate analysis included female gender, preoperative AF, age, CKD, left atrial size, OSA, preoperative AV nodal blockade, concomitant valvular surgery and moderate-severe valvular disease. On multivariable analysis, the Middle Eastern race was associated with a lower incidence of postoperative AF with a trend towards significance (OR 0.60 95% CI 0.34-1.07, P 0.081), whereas the Black race continued to be significantly associated with a lower incidence of postoperative AF (OR 0.59 95% CI 0.44-0.79, P <0.001). Other variables that continued to be significantly associated with postoperative AF included age ≥65 years (OR 1.44 P 0.007), female gender (OR 0.63 P 0.002), left atrial size index?>32 ml/kg (OR 1.64 P 0.005), moderate-severe aortic stenosis (OR 1.88 P 0.005), preoperative AF (OR 4.55 P 0.005), and AV nodal blockade (OR 0.632 P 0.019). Conclusion We report a lower prevalence of postoperative AF in Middle Eastern and Black patients. Further studies are needed to investigate the underlying associations between racial and ethnic categories and AF post CABG.

Volume

81

Issue

8

First Page

168

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