• Ramon Pierik, Miriam Zeillemaker-Hoekstra, ScheerenThomas W LTWLDepartment of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Michiel E Erasmus, Gert-Jan R Luijckx, Michiel Rienstra, Maarten Uyttenboogaart, Maarten Nijsten, and Walter M van den Bergh.
• Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: r.pierik@umcg.nl.
• J. Cardiothorac. Vasc. Anesth. 2022 Mar 1; 36 (3): 807-814.

ObjectiveThe authors aimed to study the association between postoperative atrial fibrillation (POAF) and thromboembolic stroke and to determine risk factors for thromboembolic stroke after cardiac surgery.DesignThe authors performed a secondary analysis from a randomized controlled trial (GRIP-COMPASS). The patients with thromboembolic stroke were compared with those without thromboembolic stroke, and the difference in the incidence of POAF between these groups was assessed. Odds ratios (OR) were calculated using logistic regression analyses. Brain imaging was studied for the occurrence of thromboembolic stroke during hospital admission, and POAF was monitored for seven days. To assess which characteristics were associated with occurrence of thromboembolic stroke, stepwise backward regression analysis was performed.ParticipantsAll adult consecutive cardiac surgery patients admitted postoperatively to the intensive care unit.SettingAcademic tertiary care medical center.InterventionsNone.Measurements And Main ResultsOf the 910 patients included in this study, 26 patients (2.9%) had a thromboembolic stroke during hospital admission. The incidence of POAF during the first seven days after cardiac surgery in those with thromboembolic stroke was 65%, compared with 39% in those without thromboembolic stroke: adjusted OR 3.01 (95% confidence interval, 1.13-8.00). POAF, a history of peripheral vascular disease, a higher EuroSCORE, and a longer duration of surgery were associated with thromboembolic stroke.ConclusionsPOAF within seven days after cardiac surgery was associated with a three-fold increased risk for a thromboembolic stroke during hospital admission. Expeditious treatment of POAF may, therefore, reduce early stroke risk after cardiac surgery.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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