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Women Have Lower Risk for Postoperative A-Fib After Cardiac Surgery

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Men and women with poAF have higher risk for death than those without poAF, with higher risk seen for women than men

By Elana Gotkine HealthDay Reporter

FRIDAY, Aug. 23, 2024 (HealthDay News) — Women have a lower incidence of developing postoperative atrial fibrillation (poAF) after cardiac surgery, but those with poAF have increased mortality risk compared with men with poAF, according to a study published online Aug. 21 in JAMA Network Open.

Sergey Karamnov, M.D., from Brigham and Women’s Hospital in Boston, and colleagues examined whether the incidence of poAF and associated long-term mortality after cardiac surgery differs by sex in a retrospective cohort study conducted at two tertiary care centers in Massachusetts. Adult women and men undergoing coronary artery bypass graft surgery, aortic valve surgery, mitral valve surgery, and combined procedures with cardiopulmonary bypass were evaluated. The analyses included patients who had data on poAF.

Of the 21,568 patients with poAF data, 40.8 percent of 6,601 women and 38.8 percent of 14,967 men developed poAF. The researchers found that women had a lower risk for poAF in a multivariable logistic regression model (odds ratio, 0.85). During the follow-up period, death occurred in 50.4 and 48.9 percent of women and men, respectively, in the poAF group and 49.6 and 51.1 percent of women and men, respectively, in the non-poAF group. Sex significantly moderated the association between poAF and mortality. Both men and women with poAF had significantly higher mortality risk compared with same-sex individuals without poAF (hazard ratios, 1.17 and 1.31, respectively).

“Our findings suggest that women may have protective factors against the development of poAF,” the authors write. “However, once poAF takes place, women may be more vulnerable to the associated long-term morbidities.”

Two authors disclosed ties to the pharmaceutical and medical technology industries.

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