Study: Women face higher mortality risk than men for postop atrial fibrillation after cardiac surgery

Editor's Note

A recent study from two tertiary care centers highlighted significant sex differences in long-term outcomes after cardiac surgery, especially concerning postoperative atrial fibrillation (postopAF), MedPage August 21 reports. The study, published in JAMA Network, found that while women were less likely than men to develop postopAF following a surgical procedure, they faced a higher risk of mortality if postopAF occurred.

Researchers analyzed data from over 21,000 patients who underwent various cardiac procedures, including coronary artery bypass grafting, aortic valve surgery, and mitral valve surgery. The study spanned procedures performed between 2002 and 2016, with follow-up extending to 2022.

The findings include:

• 40.8% of women and 38.8% of men developed postopAF during the study period
• Per the article, men had a 40.5% chance of developing postopAF, while women had a 37% chance of developing it
• Despite the lower probability, women with postopAF had a 31% higher mortality hazard compared to 17% in men.

The study suggests that women may possess protective factors against developing postopAF. However, once it occurs, they may be more vulnerable to long-term complications. This disparity shows the need for tailored postoperative management for women, including continuous cardiac monitoring and proactive interventions.

Experts have called for a more nuanced approach to postoperative care, emphasizing the importance of individualized monitoring and treatment to address the unique risks women face. Potential sex disparities may exist in areas such as surveillance, access to medical treatments, and overall postoperative care.

While the study provides valuable insights, it also notes limitations, including geographical constraints and underrepresentation of certain age and race groups. Additionally, the study excluded patients with certain pre-existing conditions or who had undergone specific surgical interventions.