A time-related parametric risk factor analysis for postoperative atrial fibrillation after heart surgery Spencer J. Melby, MD, James F. George, PhD,

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Presentation transcript:

A time-related parametric risk factor analysis for postoperative atrial fibrillation after heart surgery Spencer J. Melby, MD, James F. George, PhD, Desiree J. Picone, MD, Jerald Payden Wallace, MD, James E. Davies, MD, David J. George, James K. Kirklin, MD The Journal of Thoracic and Cardiovascular Surgery Volume 149, Issue 3, Pages 886-892 (March 2015) DOI: 10.1016/j.jtcvs.2014.11.032 Copyright © 2015 Terms and Conditions

Figure 1 Kaplan–Meier plot and parametric risk model for POAF. A, Combined plot showing a Kaplan–Meier plot of actuarial freedom from POAF in the entire cohort of 1583 patients in the study (closed blue circles). Overlaid onto the Kaplan–Meier plot is a nomogram of a solution for a multivariable equation (solid blue line – dotted lines represent 70% confidence limits) incorporating the time-related hazard for POAF (red line – dotted lines represent the 70% confidence limits). B, Time-related hazard for POAF with phase I (red line) and phase II (blue line) shown separately. Note that the sum of these functions results in the plot (red line) shown in A. OR, Operating room; POAF, postoperative atrial fibrillation. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 886-892DOI: (10.1016/j.jtcvs.2014.11.032) Copyright © 2015 Terms and Conditions

Figure 2 A, Predicted freedom from POAF for a white man aged 60 years with a body mass index of 28 kg/m2 and a crossclamp time of 60 minutes (solid lines) undergoing isolated CABG (blue) or mitral valve repair or replacement (red). Closed circles denote the actuarial data (Kaplan–Meier) with the standard error of the mean indicated by the error bar. Dotted lines flanking the predictive plots are the 70% confidence limits. B, Time-related hazard plots for POAF comparing isolated CABG and mitral valve procedure. C, Depiction of the ratio of the hazard for POAF in patients receiving mitral valve repair or replacement over those receiving an isolated CABG procedure with respect to time after leaving the operating room. The dotted lines represent the 70% confidence limits. Note that a ratio greater than 1 means an increased risk for AF in patients receiving a mitral valve procedure relative to those receiving isolated CABG. D, Comparison of the parametric hazard curves for patients receiving aortic valve replacement or repair, isolated CABG, or mitral valve repair or replacement. The dotted lines represent the 70% confidence limits. CABG, Coronary artery bypass grafting; OR, operating room. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 886-892DOI: (10.1016/j.jtcvs.2014.11.032) Copyright © 2015 Terms and Conditions

Figure 3 Depiction of the proportion of patients requiring antiarrhythmic medications or who experienced renal failure or cerebral vascular accidents. Proportions are a function of the total number of patients within each category. All comparisons were made using chi-square analysis. CVA, Cerebrovascular accident; POAF, postoperative atrial fibrillation. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 886-892DOI: (10.1016/j.jtcvs.2014.11.032) Copyright © 2015 Terms and Conditions