AF after CABG most common in European–Americans
MedWire News: Atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery is significantly more prevalent among European-American patients than African-American patients, research indicates.
Joseph Lindsay (Washington Hospital Center, Washington DC, USA) and colleagues note that although previous research indicates African-American patients have a lower prevalence of AF than European-American patients, little is known about the association between ethnicity and postoperative AF.
They compared the incidence of postoperative AF in 2312 African-American and 6054 European-American patients without previous AF or atrial flutter who underwent isolated CABG between July 2000 and June 2007.
Lindsay et al used telemetry to monitor the rhythm of all patients throughout their postoperative course. New-onset AF was defined when continuously present for 20 minutes or longer, or cumulatively for 1 hour or longer within a 24-hour period. The definition also included AF that required postoperative drug therapy or cardioversion.
The raw data showed that postoperative AF occurred in 22% of African-American patients, and 30% of European-American patients (p<0.01). After adjusting for baseline characteristics including age, body mass index, and hypertension, African-American patients were 37% less likely to develop AF than their European-American counterparts (p<0.001).
The researchers then matched 2059 African-American patients with the same number of European-American patients for similar propensity score. This analysis again revealed that the incidence of AF in African-American patients was lower than in European-American patients (22% vs 29%, p<0.01).
"Given the importance of AF and stroke from a public health and a cost perspective, the possibility of an ethnic difference in the development of AF should stimulate interest in study of this phenomenon… and when planning investigations into effective prophylaxis against the appearance of AF after cardiac surgery," conclude the authors.
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By Piriya Mahendra