Effect of Race on the Frequency of Postoperative Atrial Fibrillation Following Coronary Artery Bypass Grafting
Effect of Race on the Frequency of Postoperative Atrial Fibrillation Following Coronary Artery Bypass Grafting
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DOI：
10.1016/j.amjcard.2010.09.032
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发表时间：
2011-02-01
影响因子：
2.8
通讯作者：
Schuger, Claudio D.
中科院分区：
文献类型：
--
作者：
Lahiri, Marc K.;Fang, Kan;Schuger, Claudio D.
冠状动脉旁路移植术(CABG)后，房颤(AF)常合并术后病程。在普通人群中，非洲裔美国人的房颤患病率低于欧洲裔美国人。虽然已经确定了许多因素来预测术后房颤的风险，但种族还没有被检验。所有从2004年1月1日至2008年12月31日在亨利福特医院接受冠状动脉搭桥术的18岁患者均纳入研究对象。患者被排除在任何既往的房颤诊断之外，或者如果他们在冠状动脉搭桥术时同时接受了瓣膜手术。房颤的发生率由国际疾病分类第9版确定，编码来自术后住院记录。总体而言，1001名患者符合分析条件。在这些人中，731人(73%)是欧洲裔美国人，270人(27%)是非裔美国人。非裔美国人有更高的高血压(75.6%比58.8%，p<；0.001)和心力衰竭(22.6%比15.7%，p=0.001)和糖尿病的高患病率(38.1%比33.4%，p=0.159)。术后诊断为房颤的有214名欧洲裔美国人(29.3%)和50名非洲裔美国人(18.5%)(p=0.001)。在调整了年龄、性别、高血压、糖尿病和心力衰竭的多因素分析中，非洲裔美国人术后房颤的发生率低于欧洲裔美国人，调整后的优势比为0.539(95%可信区间0.374至0.777，p=0.001)。总而言之，与欧洲裔美国人相比，非裔美国人冠状动脉搭桥术后房颤的发生率显著降低。(C)2011 Elsevier Inc.保留所有权利。(美国心脏杂志2011；107：383-386)
Atrial fibrillation (AF) commonly complicates the postoperative course after coronary artery bypass grafting (CABG). Among the general population, African Americans have been shown to have a lower prevalence of AF than European Americans. Although many factors have been identified to predict risk for postoperative AF, race has not been examined. All patients aged >= 18 years who underwent CABG at Henry Ford Hospital during a 5-year period from January 1, 2004, to December 31, 2008, were included. Patients were excluded for any previous diagnosis of AF or if they had concomitant valve surgery at the time of CABG. The incidence of AF was determined by International Classification of Diseases, Ninth Revision, coding from postoperative hospitalization records. Overall, 1,001 patients were eligible for analysis. Of these, 731 (73%) were European American and 270 (27%) were African American. The African American group had a higher prevalence of hypertension (75.6% vs 58.8%, p < 0.001) and heart failure (22.6% vs 15.7%, p = 0.01) and a trend toward a higher prevalence of diabetes mellitus (38.1% vs 33.4%, p = 0.159). Postoperative AF was diagnosed in 214 European Americans (29.3%) and 50 African Americans (18.5%) (p = 0.001). In multivariate analysis adjusting for age strata, gender, hypertension, diabetes, and heart failure, African Americans had less postoperative AF than European Americans, with an adjusted odds ratio of 0.539 (95% confidence interval 0.374 to 0.777, p = 0.001). In conclusion, African Americans have a significantly reduced incidence of AF compared to European Americans after CABG. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:383-386)