Abstract
Introduction: Atrial fibrillation (AF) is a common arrhythmia after Coronary artery bypass graft (CABG). There is a paucity of data on the outcomes of CABG either On-pump CABG (ONCABG) or Off-pump CABG (OFCABG) in patients with underlying AF. Methods: We queried the National Inpatient Sample (NIS) from 2016-2019 to identify adult patients who underwent CABG (On and Off-pump) using ICD 10 codes. Patients were divided into two groups based on history of AF. Primary outcomes of interest were in-hospital mortality and mean length of stay. Other covariates of interest included sex, age, race, insurance, income quartile by zip code, comorbidities, hospital location, and size. We used the Charlson Comorbidity Index (CCI) categories to account for comorbidities. We ran multivariate regression models to investigate the possible association. Results: There were 100,715 unweighted index hospitalizations identified for ONCABG and 25,956 for OFCABG. Patients were predominantly male and white race with a mean age of 65.7 years. A total of 34,333 (34.1%) patients had underlying AF in ONCABG group and 8369 (32.24%) in the OFCABG group. Multivariate regression analysis showed that in ONCABG, AF gorup had significantly higher odds of in-hospital mortality (aOR: 1.22; 95% CI: 1.10, 1.36; p = <0.001) compared to those without AF. Similarly, in OFCABG group, AF group had significantly higher odds of in-hospital mortality (aOR: 1.26; 95% CI: 1.04, 1.52; p = 0.019) compared to those without AF after controlling for the covariates of interest and comorbidities. The mean LOS was higher in the AF group in both ONCABG (10.6 vs 8.59 days, p<0.001) and OFCABG (10.78 vs 8.77 days, p<0.001). The number of ONCABG performed each year increased from 24,761 in 2016 to 25,683 in 2019, however, the number of OFCABG decreased from 7008 in 2016 to 6179 in 2019. Conclusions: AF was associated with increased in-hospital mortality and mean LOS among the patients who underwent CABG. The number of ONCABG performed each year increased whereas the number for OFCABG decreased.
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