• Wesley T O'Neal, Jimmy T Efird, Stephen W Davies, Yuk Ming Choi, Curtis A Anderson, Linda C Kindell, Jason B O'Neal, T Bruce Ferguson, W Randolph Chitwood, and Alan P Kypson.
• Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. Electronic address: woneal@wakehealth.edu.
• Heart Lung. 2013 Nov 1; 42 (6): 442-7.

BackgroundPreoperative atrial fibrillation (AF) is associated with increased morbidity and mortality after open heart surgery. However, the impact of preoperative AF on long-term survival after open heart surgery has not been widely examined in rural populations. Patients from rural regions are less likely to receive treatment for cardiac conditions and to have adequate medical insurance coverage.ObjectiveTo examine the influence of preoperative AF on long-term survival following open heart surgery in rural eastern North Carolina.MethodsLong-term survival was compared in patients with and without preoperative AF after coronary artery bypass grafting (CABG) and CABG plus valve (CABG + V) surgery between 2002 and 2011. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model.ResultsThe study population consisted of 5438 patients. A total of 263 (5%) patients had preoperative AF. Preoperative AF was an independent predictor of long-term survival (open heart surgery: adjusted HR = 1.6, 95% CI = 1.3-2.0; CABG: adjusted HR = 1.6, 95% CI = 1.3-2.1; CABG + V: adjusted HR = 1.6, 95% CI = 1.1-2.3).ConclusionPreoperative AF is an important predictor of long-term survival after open heart surgery in this rural population.Copyright © 2013 Elsevier Inc. All rights reserved.

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