Stroke; a journal of cerebral circulation
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Meta Analysis
Perioperative/Postoperative Atrial Fibrillation and Risk of Subsequent Stroke and/or Mortality.
Background and Purpose- Although believed to be transient and self-limiting, new-onset perioperative/postoperative atrial fibrillation (POAF) might be a risk factor for stroke and mortality. We conducted a systematic review and meta-analysis to qualitatively and quantitatively evaluate the relationship of POAF with early and late risks of mortality and stroke. Methods- We searched Pubmed, EMBASE, and Cochrane Library (1966 through March 2018) to identify cohort studies that reported stroke and mortality associated with POAF. ⋯ In subgroup analyses, POAF was more strongly associated with stroke in patients undergoing noncardiac surgery (HR, 2.00; 95% CI, 1.70-2.35) than in patients undergoing cardiac surgery (HR, 1.20; 95% CI, 1.07-1.34). Conclusions- New-onset POAF is associated with an increased risk of stroke and mortality, both in the short-term and long-term. The best strategy to reduce stroke risk among these patients needs to be determined.