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Perioperative Inotrope Therapy and Atrial Fibrillation Following Coronary Artery Bypass Graft Surgery: Evidence of a Racial Disparity
Journal article

Perioperative Inotrope Therapy and Atrial Fibrillation Following Coronary Artery Bypass Graft Surgery: Evidence of a Racial Disparity

Jimmy T Efird, Andy C Kiser, Patricia B Crane, Hope Landrine, Linda C Kindell, Margaret-Ann Nelson, Charulata Jindal, Daniel F Sarpong, William F Griffin, T Bruce Ferguson, …
Pharmacotherapy, Vol.37(3), pp.297-304
03/2017
DOI: 10.1002/phar.1894
PMCID: PMC5505772
PMID: 28052357
url
http://doi.org/10.1002/phar.1894View
Open Access

Abstract

Following coronary artery bypass graft (CABG) surgery, mortality rates are significantly higher among black patients who experience postoperative atrial fibrillation (POAF). Perioperative inotropic therapy (PINOT) was associated with POAF in previous reports, but the extent to which race influences this association is unknown. In the present study, the relationship between PINOT, race, and POAF was examined in patients undergoing CABG surgery. Clinical records were examined from a prospectively maintained cohort of 11,855 patients (median age 64 yrs; 70% male; 16% black) undergoing primary isolated CABG at a large cardiovascular institute in the southeastern region of the United States. Relative risk (RR) and 95% confidence intervals (CIs) were computed using log-binomial regression. The association between PINOT and POAF was significantly increased among black patients (adjusted RR 1.7, CI 1.4-2.0) compared with white patients (adjusted RR 1.3, CI 1.2-1.4) (p  = 0.013). These findings suggest that PINOT may be disproportionately associated with POAF among black patients undergoing CABG surgery. Additional studies are needed to examine further the potential underlying mechanisms of this association.
Coronary Artery Bypass - methods Prospective Studies Health Status Disparities Humans Middle Aged Atrial Fibrillation - ethnology European Continental Ancestry Group - statistics & numerical data Male Risk Postoperative Complications - epidemiology African Continental Ancestry Group - statistics & numerical data Coronary Artery Bypass - adverse effects Cardiotonic Agents - administration & dosage Atrial Fibrillation - epidemiology Cardiotonic Agents - adverse effects Postoperative Complications - ethnology Atrial Fibrillation - etiology Perioperative Care - methods Female Aged

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