Atrial fibrillation in vascular surgery: a systematic review and meta-analysis on prevalence, incidence and outcome implications.
J Cardiovasc Med (Hagerstown)
; 24(9): 612-624, 2023 09 01.
Article
en En
| MEDLINE
| ID: mdl-37605953
ABSTRACT
AIMS:
To know the prevalence of atrial fibrillation (AF), as well as the incidence of postoperative AF (POAF) in vascular surgery for arterial diseases and its outcome implications.METHODS:
We performed a systematic review and meta-analysis following the PRISMA statement.RESULTS:
After the selection process, we analyzed 44 records (30 for the prevalence of AF history and 14 for the incidence of POAF).The prevalence of history of AF was 11.5% [95% confidence interval (CI) 1-13.3] with high heterogeneity (I2â=â100%). Prevalence was higher in the case of endovascular procedures. History of AF was associated with a worse outcome in terms of in-hospital death [odds ratio (OR) 3.29; 95% CI 2.66-4.06; Pâ<â0.0001; I2 94%] or stroke (OR 1.61; 95% CI 1.39-1.86; Pâ<â0.0001; I2 91%).The pooled incidence of POAF was 3.6% (95% CI 2-6.4) with high heterogeneity (I2â=â100%). POAF risk was associated with older age (mean difference 4.67âyears, 95% CI 2.38-6.96; Pâ=â0.00007). The risk of POAF was lower in patients treated with endovascular procedures as compared with an open surgical procedure (OR 0.35; 95% CI 0.13-0.91; Pâ=â0.03; I2â=â61%).CONCLUSIONS:
In the setting of vascular surgery for arterial diseases a history of AF is found overall in 11.5% of patients, more frequently in the case of endovascular procedures, and is associated with worse outcomes in terms of short-term mortality and stroke.The incidence of POAF is overall 3.6%, and is lower in patients treated with an endovascular procedure as compared with open surgery procedures. The need for oral anticoagulants for preventing AF-related stroke should be evaluated with randomized clinical trials.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
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Accidente Cerebrovascular
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Procedimientos Endovasculares
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Prevalence_studies
/
Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
J Cardiovasc Med (Hagerstown)
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2023
Tipo del documento:
Article