Risk of stroke, death similar between postoperative, nonoperative AF

Thromboembolism risk is similar between patients with atrial fibrillation (AF) following a noncardiac surgery and those with nonoperative AF, suggest the results of a recent study.

This cohort study conducted in Olmsted County, Minnesota, US, included 4,231 patients with incident AF between 2000 and 2013. The authors categorized patients as having AF occurring within 30 days of a noncardiac surgery (postoperative AF) or having AF unrelated to surgery (nonoperative AF).

Of the patients, 550 (13 percent) had postoperative AF as their first-ever documented AF presentation. A total of 486 patients had an ischaemic stroke or transient ischaemic attack (TIA) and 2,462 had subsequent AF over a mean follow-up of 6.3 years. In addition, 2,565 deaths were recorded.

The risk for stroke or TIA was comparable between patients with postoperative AF and those with nonoperative AF (absolute risk difference [ARD] at 5 years, 0.1 percent, 95 percent confidence interval [CI], ‒2.9 percent to 3.1 percent; hazard ratio [HR], 1.01, 95 percent CI, 0.77‒1.32).

Patients with postoperative AF, however, had a lower risk for subsequent AF (ARD at 5 years, ‒13.4 percent, 95 percent CI, ‒17.8 to ‒9.0; HR, 0.68, 95 percent CI, 0.60‒0.77).

Furthermore, there was no difference seen in cardiovascular or all-cause death between postoperative AF and nonoperative groups.

“Our findings have potentially important implications for the early postsurgical and subsequent management of postoperative AF,” the authors said.

This study was limited by a predominantly White sample. Caution must be exercised when extrapolating the results to more racially diverse populations.