Postoperative Atrial Fibrillation and Long-Term Risk of Stroke in Patients Undergoing Liver Transplantation.

Adult Aged Atrial Fibrillation / epidemiology Cohort Studies Female Humans Incidence Liver Transplantation / adverse effects Male Middle Aged Postoperative Complications / epidemiology Retrospective Studies Stroke / epidemiology
atrial fibrillation cardiovascular diseases mortality risk assessment thromboembolism

Journal

Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266

Informations de publication

Date de publication:
01 2021
Historique:
pubmed: 23 12 2020
medline: 17 4 2021
entrez: 22 12 2020
Statut: ppublish

Résumé

Postoperative atrial fibrillation (POAF) is the commonest cardiovascular complication following liver transplantation (LT). This study sought to assess a possible association of POAF with subsequent thromboembolic events in patients undergoing LT. A retrospective cohort study of consecutive adults undergoing LT between 2010 and 2018 was undertaken. Patients were classified as POAF if atrial fibrillation (AF) was documented within 30 days of LT without a prior history of AF. Cases of ischemic stroke or systemic embolism were adjudicated by a panel of 2 independent physicians. Among the 461 patients included, POAF occurred in 47 (10.2%) a median of 3 days following transplantation. Independent predictors of POAF included advancing age, postoperative sepsis and left atrial enlargement. Over a median follow-up of 4.9 (interquartile range, 2.9-7.2) years, 21 cases of stroke and systemic embolism occurred. Rates of thromboembolic events were significantly higher in patients with POAF (17.0% versus 3.1%; POAF following LT is associated with an 8-fold increased risk of thromboembolic events and the use of the CHA

Sections du résumé

BACKGROUND AND PURPOSE
Postoperative atrial fibrillation (POAF) is the commonest cardiovascular complication following liver transplantation (LT). This study sought to assess a possible association of POAF with subsequent thromboembolic events in patients undergoing LT.
METHODS
A retrospective cohort study of consecutive adults undergoing LT between 2010 and 2018 was undertaken. Patients were classified as POAF if atrial fibrillation (AF) was documented within 30 days of LT without a prior history of AF. Cases of ischemic stroke or systemic embolism were adjudicated by a panel of 2 independent physicians.
RESULTS
Among the 461 patients included, POAF occurred in 47 (10.2%) a median of 3 days following transplantation. Independent predictors of POAF included advancing age, postoperative sepsis and left atrial enlargement. Over a median follow-up of 4.9 (interquartile range, 2.9-7.2) years, 21 cases of stroke and systemic embolism occurred. Rates of thromboembolic events were significantly higher in patients with POAF (17.0% versus 3.1%;
CONCLUSIONS
POAF following LT is associated with an 8-fold increased risk of thromboembolic events and the use of the CHA

Identifiants

DOI: 10.1161/STROKEAHA.120.031454 PMID: 33349017
pubmed: 33349017
doi: 10.1161/STROKEAHA.120.031454
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

111-120

Auteurs

Anoop N Koshy (AN)

Department of Cardiology (A.N.K., A.E., H.-C.H., M.H., J.K., H.S.L., O.F., A.W.T.), Austin Health, Melbourne, Victoria, Australia.
The University of Melbourne, Parkville, Victoria, Australia (A.N.K., L.W., H.-C.H., M.H., P.J.G., V.T., A.T., H.S.L., O.F., A.W.T.).
Victorian Liver Transplant Unit, Austin Hospital, Melbourne, Australia (A.N.K., L.W., P.J.G., A.T.).

Anees Enyati (A)

Department of Cardiology (A.N.K., A.E., H.-C.H., M.H., J.K., H.S.L., O.F., A.W.T.), Austin Health, Melbourne, Victoria, Australia.

Laurence Weinberg (L)

Department of Anaesthesia (L.W.), Austin Health, Melbourne, Victoria, Australia.
The University of Melbourne, Parkville, Victoria, Australia (A.N.K., L.W., H.-C.H., M.H., P.J.G., V.T., A.T., H.S.L., O.F., A.W.T.).
Victorian Liver Transplant Unit, Austin Hospital, Melbourne, Australia (A.N.K., L.W., P.J.G., A.T.).

Hui-Chen Han (HC)

Department of Cardiology (A.N.K., A.E., H.-C.H., M.H., J.K., H.S.L., O.F., A.W.T.), Austin Health, Melbourne, Victoria, Australia.
The University of Melbourne, Parkville, Victoria, Australia (A.N.K., L.W., H.-C.H., M.H., P.J.G., V.T., A.T., H.S.L., O.F., A.W.T.).

Mark Horrigan (M)

Department of Cardiology (A.N.K., A.E., H.-C.H., M.H., J.K., H.S.L., O.F., A.W.T.), Austin Health, Melbourne, Victoria, Australia.
The University of Melbourne, Parkville, Victoria, Australia (A.N.K., L.W., H.-C.H., M.H., P.J.G., V.T., A.T., H.S.L., O.F., A.W.T.).

Paul J Gow (PJ)

The University of Melbourne, Parkville, Victoria, Australia (A.N.K., L.W., H.-C.H., M.H., P.J.G., V.T., A.T., H.S.L., O.F., A.W.T.).
Victorian Liver Transplant Unit, Austin Hospital, Melbourne, Australia (A.N.K., L.W., P.J.G., A.T.).

Jefferson Ko (J)

Department of Cardiology (A.N.K., A.E., H.-C.H., M.H., J.K., H.S.L., O.F., A.W.T.), Austin Health, Melbourne, Victoria, Australia.

Vincent Thijs (V)

Stroke Division, Florey Institute of Neuroscience and Mental Health and Department of Neurology (V.T.), Austin Health, Melbourne, Victoria, Australia.
The University of Melbourne, Parkville, Victoria, Australia (A.N.K., L.W., H.-C.H., M.H., P.J.G., V.T., A.T., H.S.L., O.F., A.W.T.).

Adam Testro (A)

The University of Melbourne, Parkville, Victoria, Australia (A.N.K., L.W., H.-C.H., M.H., P.J.G., V.T., A.T., H.S.L., O.F., A.W.T.).
Victorian Liver Transplant Unit, Austin Hospital, Melbourne, Australia (A.N.K., L.W., P.J.G., A.T.).

Han S Lim (HS)

Department of Cardiology (A.N.K., A.E., H.-C.H., M.H., J.K., H.S.L., O.F., A.W.T.), Austin Health, Melbourne, Victoria, Australia.
The University of Melbourne, Parkville, Victoria, Australia (A.N.K., L.W., H.-C.H., M.H., P.J.G., V.T., A.T., H.S.L., O.F., A.W.T.).

Omar Farouque (O)

Department of Cardiology (A.N.K., A.E., H.-C.H., M.H., J.K., H.S.L., O.F., A.W.T.), Austin Health, Melbourne, Victoria, Australia.
The University of Melbourne, Parkville, Victoria, Australia (A.N.K., L.W., H.-C.H., M.H., P.J.G., V.T., A.T., H.S.L., O.F., A.W.T.).

Andrew W Teh (AW)

Department of Cardiology (A.N.K., A.E., H.-C.H., M.H., J.K., H.S.L., O.F., A.W.T.), Austin Health, Melbourne, Victoria, Australia.
The University of Melbourne, Parkville, Victoria, Australia (A.N.K., L.W., H.-C.H., M.H., P.J.G., V.T., A.T., H.S.L., O.F., A.W.T.).
Cardiology Department, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia (A.W.T.).

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Postoperative Atrial Fibrillation and...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Postoperative Atrial Fibrillation and...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Fibrillation auriculaire › Postoperative Atrial Fibrillation and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Postoperative Atrial Fibrillation and...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Postoperative Atrial Fibrillation and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Incidence › Postoperative Atrial Fibrillation and...
questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation de tissu › Transplantation hépatique › Postoperative Atrial Fibrillation and...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Postoperative Atrial Fibrillation and...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Complications postopératoires › Postoperative Atrial Fibrillation and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Postoperative Atrial Fibrillation and...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Postoperative Atrial Fibrillation and...