New-onset atrial fibrillation following coronary bypass surgery predicts long-term mortality: a systematic review and meta-analysis

Kevin Phan, Hakeem S. K. Ha, Steven Phan, Caroline Medi, Stuart P. Thomas, Tristan D. Yan*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

93 Citations (Scopus)


Atrial fibrillation (AF) is one of the most common postoperative complications following cardiac surgery. Recent evidence suggests that postoperative atrial fibrillation (POAF) may be more 'malignant' than previously thought, associated with follow-up mortality and morbidity. To evaluate the long-term survival of POAF versus No-POAF cohorts following coronary bypass surgery, the current meta-analysis with reconstructed individual patient data was performed. Electronic searches were performed using six databases from their inception to August 2014. Relevant studies with long-term survival data presented for POAF versus No-POAF were identified. Data were extracted by two independent reviewers and analysed according to predefined clinical endpoints. The pooled hazard ratio (HR) significantly favoured higher survival in No-POAF over POAF (HR 1.28; 95% CI, 1.19-1.37; I2 = 96%; P < 0.00001). Individual patient data of 69 518 patients were available for inverted Kaplan-Meier survival curve analysis. Analysis of aggregate data using Kaplan-Meier curve methods for POAF versus No-POAF groups determined survival rates at the 1-year (95.7 vs 98%), 2-year (92.3 vs 95.4%), 3-year (88.7 vs 93.9%), 5-year (82.6 vs 89.4%) and 10-year (65.5 vs 75.3%) follow-up. Other complications including 30-day mortality, strokes, respiratory failure, pneumonia and hospitalization were significantly higher in the POAF group. New-onset AF following coronary bypass surgery is associated with significantly higher risk of mortality in short- and long-term follow-up. Current evidence suggests the need for stricter surveillance and monitoring of POAF following coronary bypass surgery.

Original languageEnglish
Pages (from-to)817-824
Number of pages8
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number6
Publication statusPublished - 2015


  • Atrial fibrillation
  • Coronary bypass
  • Meta-analysis
  • Outcomes


Dive into the research topics of 'New-onset atrial fibrillation following coronary bypass surgery predicts long-term mortality: a systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this