Abstract
Background
Methods
Results
Conclusions
Résumé
Contexte
Méthodologie
Résultats
Conclusions
- Thorén E.
- Wernroth M.L.
- Christersson C.
- et al.
Methods
Search methods
Study selection and outcome assessment
Data extraction
Assessment of the quality of evidence
Wells G, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed March 9, 2021.
Statistical analysis
Deeks J, Higgins J, Altman D. Analysing data and undertaking meta-analyses. In: Cochrane Handbook for Systematic Reviews of Interventions. Vol 2020. Cochrane: 2019. Available at: https://training.cochrane.org/handbook. Accessed December 8, 2021.
Schünemann HJ, Viste GE, Higgings JPT, et al. Interpreting results and drawing conclusions. In: Higgins JPT, Santesso N, Deesk JJ, Glasziou P, eds. Cochrane Handbook for Systematic Reviews of Interventions. city: Cochrane; 2020. Available at: www.training.cochrane.org/handbook. Accessed December 8, 2021.
Results
Study selection
- Thorén E.
- Wernroth M.L.
- Christersson C.
- et al.
- Hu J.
- Peng L.
- Qian H.
- et al.

Study characteristics
Author | Year | Country | Surgery type | N | POAF (% incidence) | Age (POAF / no POAF) | Female sex (%) (POAF / no POAF) | Stroke outcomes (short-term / long-term) | Multivariable adjusted results (short-term / long-term) | Follow-up (years) |
---|---|---|---|---|---|---|---|---|---|---|
Ahlsson 21 | 2010 | Sweden | Isolated CABG | 571 | 28.9 | 69 / 65 | 18.8 / 22.9 | - / ∗ | - / - | 6.9 |
Al-Khatib 22 | 2009 | USA | Isolated CABG | 2794 | 23.7 | 67 / 61 | 18.6 / 21.2 | ∗ / - | - / - | — |
Almassi 24 | 1997 | USA | CABG, valvular, combination, other | 3855 | 29.7 | 67 / 62 | 1.14 / 1.73 | ∗ / - | - / - | — |
Almassi 23 | 2019 | USA | Isolated CABG | 2103 | 26.2 | 65 /62 | 0.1 | ∗ / ∗ | - / - | 5 |
Attaran 25 | 2011 | UK | CABG, valvular, combination, other | 17379 | 28.7 | 68 / 64 | 25.4 / 26.5 | ∗ / - | ∗ / - | — |
Auer 26 | 2005 | Austria | Valvular ± CABG | 253 | 39.1 | 68 / 64 | 44.5 / 37.0 | ∗ / - | - / - | — |
Barbieri 27 | 2013 | Portugal | Isolated CABG | 2628 | 12.4 | 67 / 61 | 26.7 / 30.6 | ∗ / - | - / - | — |
Batra 28 | 2019 | Sweden | Isolated CABG | 8370 | 27.4 | 70 / 66 | 17.4 / 19.3 | - / ∗ | - / ∗ | 2.2 |
Benedetto 29 | 2020 | International | Isolated CABG | 3023 | 24.2 | 66 / 63 | 13.5 / 14.5 | ∗ / ∗ | - / ∗ | 10 |
Biancari 30 | 2013 | Finland | Isolated CABG | 1226 | 31.3 | 67 / 62 | 28.4 / 25.4 | ∗ / ∗ | ∗ / ∗ | 7.2 |
Bramer 31 | 2010 | The Netherlands | Isolated CABG | 5098 | 22.0 | 69 / 64 | 21.2 / 22.5 | ∗ / - | - / - | — |
Bramer 32 | 2011 | The Netherlands | MVR ± (CABG or TVR) | 856 | 42.2 | 67 / 63 | 37.4 / 41.4 | ∗ / - | - / - | — |
Butt 3 | 2019 | Denmark | Isolated valvular | 1528 | 46.6 | 71 / 68 | 41.4 / 38 | - / ∗ | - / ∗ | 4.7 |
Butt 12 | 2018 | Denmark | Isolated CABG | 7121 | 30.3 | 68/ 64 | 17.7 / 17.9 | - / ∗ | - / ∗ | 5.5 |
Choi 33 | 2009 | South Korea | Isolated CABG | 315 | 21.0 | 67 / 65 | 25.8 / 29.3 | ∗ / - | - / - | — |
Coletta 33 | 2019 | USA | Isolated CABG | 158 | 29.5 | — | 16.7 / 30.3 | ∗ / - | - / - | — |
Conen 14 | 2020 | Canada | Isolated CABG | 4624 | 16.8 | 71 / 66 | 19.8 / 19.2 | ∗ / ∗ | - / ∗ | 4.4 |
Echahidi 35 | 2007 | Canada | Isolated CABG | 5085 | 27.0 | 68 / 63 | 23.0 / 23.8 | ∗ / - | - / - | — |
El-Chami 9 | 2010 | USA | Isolated CABG | 16169 | 18.5 | 68 / 61 | 26.9 / 28.3 | ∗ / - | - / - | — |
Farouk Musa 36 | 2018 | Malaysia | Isolated CABG | 637 | 28.7 | 62 / 60 | 20.8 / 17.2 | ∗ / - | - / - | — |
Ghurram 38 | 2020 | India | Isolated CABG | 748 | 17.0 | — | — | ∗ / ∗ | - / - | 1.7 |
Gialdini 37 | 2014 | USA | CABG, valvular, combination, other | 73543 | 16.1 | — | — | - / ∗ | - / ∗ | 1 |
Girerd 39 | 2012 | Canada | Isolated CABG | 6728 | 27.8 | 68 / 63 | 22.6 / 22.0 | ∗ / - | - / - | |
Guenancia 40 | 2015 | France | Isolated CABG | 100 | 34.0 | 66 / 63 | 8.8 / 6.1 | ∗ / ∗ | - / - | 1 |
Horwich 41 | 2013 | Canada | Isolated CABG | 8058 | 27.5 | — | 22.7 / 25.3 | ∗ / ∗ | - / ∗ | 5.7 |
Hravnak 42 | 2002 | USA | Isolated CABG | 814 | 31.9 | 70 / 64 | 29.6 / 34.5 | ∗ / - | - / - | — |
Hu 43
Transoesophageal echocardiography for prediction of postoperative atrial fibrillation after isolated aortic valve replacement: two-dimensional speckle tracking for intraoperative assessment of left ventricular longitudinal strain. Eur J Cardiothorac Surg. 2015; 47: 833-839 | 2015 | China | Isolated AVR | 107 | 34.6 | 56 / 50 | 62.2 / 58.6 | ∗ / - | - / - | — |
Iliescu 44 | 2018 | Romania | Isolated AVR | 1191 | 28.7 | 69 / 64 | 36.8 / 30.2 | ∗ / - | - / - | — |
Kalra 45 | 2019 | USA | Isolated AVR | 122765 | 50.1 | 72 / 64 | 38.1 / 40.0 | ∗ / - | ∗ / - | — |
Kalra (validation cohort) 45 | 2019 | USA | Isolated AVR | 5141 | 30.6 | 72 / 65 | 41.4 / 41.3 | ∗ / - | ∗ / - | — |
Kim 46 | 2020 | South Korea | AVR ± other | 296 | 52.0 | 67 | 44.9 | ∗ / - | ∗ / - | |
Kohno 47 | 2017 | Japan | AVR ± other | 157 | 36.9 | 71 / 67 | 46.6 / 49.5 | - / ∗ | - / - | 4.4 |
Konstantino 48 | 2016 | Israel | Isolated CABG | 136 | 27.2 | 76 / 70 | 32.4 / 19.2 | ∗ / ∗ | - / - | 8.5 |
Lapar 49 | 2014 | USA | CABG, valvular, combination | 49264 | 18.8 | 69 / 63 | 28.9 / 28.9 | ∗ / - | ∗ / - | — |
Lee 50 | 2014 | South Korea | Isolated CABG | 1171 | 20.8 | 67 / 63 | 25.0 / 30.1 | ∗ / - | ∗ / - | — |
Lotfi 1 | 2011 | USA | Isolated CABG | 3068 | 38.4 | 70 / 64 | 28.9 / 29.2 | ∗ / - | - / - | — |
Mariscalco 10 | 2014 | UK, Italy | CABG, valvular, combination | 17262 | 26.4 | 70 / 65 | 27.9 / 23.8 | ∗ / - | - / - | — |
Nisanolgu 51 | 2007 | Turkey | Isolated CABG | 426 | 21.4 | 71 / 70 | 27.5 / 31.3 | ∗ / - | - / - | — |
O'Neal 52 | 2013 | USA | Isolated CABG | 13165 | 22.1 | 68 / 62 | 27.0 / 30.0 | ∗ / - | - / - | — |
Philip 53 | 2014 | USA | Isolated CABG | 5135 | 29.0 | 68 / 63 | 27.2 / 29.0 | ∗ / ∗ | - / - | 1 |
Pivatto Junior 54 | 2014 | Brazil | Isolated AVR | 348 | 32.8 | 77 / 77 | 48.2 / 41.9 | ∗ / - | - / - | — |
Rubin 55 | 1987 | USA | Isolated CABG | 123 | 29.3 | 59 / 54 | — | ∗ / ∗ | - / - | 2.2 |
Saxena 56 | 2012 | Australia | Isolated CABG | 19497 | 28.5 | 69 / 64 | — | ∗ / - | ∗ / - | — |
Shen 57 | 2011 | USA | CABG, valvular, combination, other | 10390 | 30.2 | — | 35.7 / 35.0 | ∗ / - | - / - | — |
Silva 58 | 2004 | Brazil | CABG, valvular, combination | 158 | 28.5 | - | 37.8 / 35.4 | ∗ / - | - / - | - |
Stamou 59 | 2000 | USA | Isolated CABG (off-pump) | 969 | 21.3 | 69 / 61 | 33.5 / 33.4 | ∗ / - | - / - | - |
Swinkels 60 | 2017 | The Netherlands | Isolated AVR | 569 | 42.4 | 65 / 64 | 44.4 / 43.6 | ∗ / ∗ | - / - | 17.8 |
Thoren 13
Compared with matched controls, patients with postoperative atrial fibrillation (POAF) have increased long-term AF after CABG, and POAF is further associated with increased ischemic stroke, heart failure and mortality even after adjustment for AF. Clin Res Cardiol. 2020; 109: 1232-1242 | 2020 | Sweden | Isolated CABG | 7145 | 30.6 | 69 / 65 | 21.0 / 23.0 | - / ∗ | - / ∗ | 9.8 |
Thoren 11 | 2014 | Sweden | Isolated CABG | 6821 | 31.6 | 69 / 65 | 21.0 / 23.0 | ∗ / - | - / - | - |
Villareal 61 | 2004 | USA | Isolated CABG | 6475 | 15.4 | 68 / 62 | 26.7 / 26.1 | ∗ / - | ∗ / - | - |
Vlahou 62 | 2016 | Greece | Isolated CABG | 446 | 24.9 | 68 / 64 | 16.2 / 14.6 | ∗ / - | - / - | - |
Vural 63 | 2019 | Turkey | Isolated CABG | 756 | 21.3 | - | 32.3 / 29.7 | ∗ / - | - / - | - |
Whitlock 2 | 2014 | Canada | CABG, valvular, combination | 99137 | 18.2 | - | 26.4 / 24.9 | ∗ / ∗ | ∗ / ∗ | 2 |
Yokota 64 | 2017 | Japan | Valvular ± other | 119 | 39.5 | 76 / 71 | 48.9 / 45.8 | ∗ / - | - / - | - |
Zangrillo 65 | 2004 | Italy | Isolated CABG | 160 | 20.6 | 68 / 64 | 12.1 / 15.7 | ∗ / - | - / - | - |
Zhao 66 | 2015 | Singapore | CABG ± valvular | 160 | 22.6 | 62 | 14.3 | ∗ / - | - / - | - |
Quality of studies
Risk of short-term stroke


Risk of long-term stroke

Anticoagulation use
Meta-regression and sensitivity analyses
Discussion
- Hindricks G.
- Potpara T.
- Dagres N.
- et al.
Anticoagulation for New-Onset Post-Operative Atrial Fibrillation After CABG (PACES). Available at: https://clinicaltrials.gov/ct2/show/NCT04045665. Accessed March 9, 2021.
- Hindricks G.
- Potpara T.
- Dagres N.
- et al.
Conclusion
Funding Sources
Disclosures
Supplementary Material
- Supplementary Material
References
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Ethics Statement: This systematic review and meta-analysis was conducted in accordance to the ethical principles described in the Declaration of Helsinki.
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