Background. The present multicentre study was
aimed at determining the effect of preoperative atrial fibrillation (preop-AF) as stroke
risk factor in coronary artery bypass graft surgery (CABG) during the perioperative
Methods. Patients undergoing isolated CABG surgery
were enrolled from 21 Spanish centers. Baseline variables related with
perioperative stroke risk were recorded and analysed. The Northern New England Cardiovascular Disease
Study Group (NNECVDSG) stroke risk schema was used to stratify
stroke risk and compare predicted vs observed neurologic outcomes in this
Results. 26347 patients were enrolled in the study.
Prevalence of preop-AF was 4.2%, and was associated significantly with major
cardiovascular comorbidities. The stroke rate was 1.38% (365 strokes), and it was
slightly higher for patients with preop-AF vs non preop-AF, 1.82% vs 1.36%, p = 0.2. NNECVDSG schema showed good predictive ability
calculating the area under the receiver operating characteristic curve (c-statistic 0.696; 95% CI 0.668 to 0.723). To investigate the associations of baseline
preoperative variables with perioperative CABG-stroke a logistic regression
model was performed. Preop-AF impact on perioperative stroke was lower that
other variables. Preop-AF did not show an
adverse impact in the quartiles groups according to NNECVDSG Stroke Risk Index.
Conclusions. Risk of perioperative stroke in isolated CABG
surgery patients is not significantly increased by preop-AF.
Credits: Hornero F; Martín E; Mena-Durán; AV, Rodríguez R; Castellà M; Porras C; Romero B; Maroto L; Pérez de la Sota E; Echevarría M; Dalmau MJ; Díez L; Buendía J; Enríquez F; Castaño M; Reyes G; Ginel A; Pérez M; Barquero J; Jiménez A; Castedo E; Pradas G; Gómez M