Related Experiment Video
Updated: Jul 29, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Incidence of stroke in patients with atrial fibrillation undergoing surgical treatment: a meta-analysis
Deqing Lin1, Yongbo Cheng1, Sanjiu Yu1
1Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, P.R. China.
Insights
Atrial fibrillation (AF) increases stroke risk in cardiac surgery patients. This meta-analysis found higher stroke risk after heart valve surgery and general cardiac procedures in AF patients.
Area of Science:
- Cardiology
- Neurology
- Surgical Outcomes
Background:
- Atrial fibrillation (AF) is a condition that can lead to stroke and death.
- The association between AF and stroke risk in surgical patients requires thorough investigation.
Purpose of the Study:
- To assess the risk of stroke in patients with atrial fibrillation undergoing cardiac surgery.
- To statistically analyze the link between AF and postoperative ischemic stroke using meta-analysis.
Main Methods:
- Systematic review and meta-analysis of 16 studies involving 132,208 patients.
- Searched PubMed, EMBASE, Science Direct, Google Scholar, and Cochrane Library.
- Utilized random-effect network meta-analysis for direct and indirect comparisons.
Main Results:
- Higher stroke risk observed after heart valve surgery in AF patients (HR 1.5).
- General cardiac surgery in AF patients showed a pooled odds ratio of 2 for increased stroke risk.
- Coronary Artery Bypass Grafting (CABG) showed an odds ratio of 1.1 for stroke risk in AF patients.
Conclusions:
- The study quantifies stroke outcomes in cardiac surgery patients with AF.
- Further research is needed to fully understand and mitigate stroke risks in this population.
Introduction:
Atrial fibrillation (AF) is self-limiting condition, but it may also increase the risk of stroke and death. The association between AF and surgery with stroke was assessed both subjectively and statistically using systematic review and meta-analysis.
Methods:
For data collection, a thorough search was made in PubMed, EMBASE, Science Direct, Google Scholar, and Cochrane Library using searching keywords "postoperative ischemic stroke, atrial fibrillation, stroke, cardiac surgery, brain ischemia, and heart surgery". Direct and indirect comparisons were made using random-effect network meta-analysis.
Results:
16-studies were identified comprising of 132,208 patient, 64% male, median age > 63 years and follow-up > 1.5 years. Pooling the results from the random-effects model showed odds ratios associated with the risk of stroke of surgical processes (CABG) in patients with AF. The odds ratio OR = 1.1 (0.65-1.54, P < 0.001) and heterogeneity (I2 = 17%, P = 0.13) exposing higher risk of the stroke. Odds ratio (HR 1.5, 0.9-1.71) without heterogeneity showed greater risk of stroke after heart valve surgery in patients with AF. Study 8 didn't show any risk of the stroke after left atrial appendage (LAA) clipping intervention, but the outcomes were biased. A pooled analysis showed odd ratio OR, 2 (1.7-2.1, P < 0.0001), without heterogeneity indicating higher stroke risk in general cardiac surgery. The patients undergone cardiac surgery from three studies with pooled analysis study-5 OR 2 (1.7-2.1, P > 0.001), study-6 OR 1.8 (1.7-1.9, P > 0.001), and study-14 OR 7.8 (6.2-8.1, P > 0.0001).
Conclusion:
The study clearly defines stroke outcomes when they are quantified, however, further research is required.
