Risk of Thromboembolism Associated With Atrial Fibrillation Following Noncardiac Surgery

The long-term risk of thromboembolism in patients developing new-onset post-operative atrial fibrillation (POAF) following noncardiac surgery is unknown, and data on stroke prophylaxis in this setting are lacking. The purpose of this study was to assess the long-term risk of thromboembolism in patie...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2018-10, Vol.72 (17), p.2027-2036
Main Authors: Butt, Jawad H., Olesen, Jonas B., Havers-Borgersen, Eva, Gundlund, Anna, Andersson, Charlotte, Gislason, Gunnar H., Torp-Pedersen, Christian, Køber, Lars, Fosbøl, Emil L.
Format: Article
Language:English
Subjects:
Age
Aged
Alcohol
Anticoagulants
Anticoagulants - therapeutic use
atrial fibrillation
Atrial Fibrillation - diagnosis
Atrial Fibrillation - drug therapy
Atrial Fibrillation - epidemiology
Atrial Fibrillation - etiology
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Confidence intervals
Coronary artery disease
Denmark - epidemiology
Diabetes
Diabetes mellitus
Embolisms
epidemiology
Female
Fibrillation
Health risk assessment
Heart diseases
Heart failure
Heart surgery
Hospitals
Humans
Hypertension
Identification methods
Ischemia
Long Term Adverse Effects - diagnosis
Long Term Adverse Effects - etiology
Long Term Adverse Effects - prevention & control
Male
Middle Aged
Patients
Postoperative Complications - diagnosis
Postoperative Complications - drug therapy
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Prescriptions
Prophylaxis
Registries - statistics & numerical data
Regression analysis
Risk Assessment
Risk Factors
Statistical analysis
Stroke
Surgery
Surgical Procedures, Operative - adverse effects
Therapy
Thorax
Thromboembolism
Thromboembolism - diagnosis
Thromboembolism - etiology
Thromboembolism - prevention & control
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The long-term risk of thromboembolism in patients developing new-onset post-operative atrial fibrillation (POAF) following noncardiac surgery is unknown, and data on stroke prophylaxis in this setting are lacking. The purpose of this study was to assess the long-term risk of thromboembolism in patients developing new-onset POAF following noncardiac surgery relative to patients with nonsurgical, nonvalvular atrial fibrillation (NVAF). Using Danish nationwide registries, the authors identified all patients who developed POAF following noncardiac surgery from 1996 to 2015. These were matched by age, sex, heart failure, hypertension, diabetes, previous thromboembolism, ischemic heart disease, and year of diagnosis to patients with nonsurgical NVAF in a 1:4 ratio. Comparative long-term risk of thromboembolism was examined by multivariable Cox regression models. In patients undergoing noncardiac surgery, 6,048 (0.4%) developed POAF during hospitalization, with the highest incidences following thoracic/pulmonary, vascular, and abdominal surgery. A total of 3,830 patients with POAF were matched with 15,320 patients with NVAF. Oral anticoagulation therapy was initiated within 30 days post-discharge in 24.3% and 41.3% of these patients, respectively (p value 
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2018.07.088