{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:06:11Z","timestamp":1790697971709,"version":"4.1.0"},"reference-count":19,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Association of Cardiovascular Prevention and Rehabilitation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Postoperative atrial fibrillation (POAF) is a common complication of coronary artery bypass grafting (CABG) and may recur during cardiac rehabilitation (CR); its long-term prognostic value remains unclear. We evaluated the impact of POAF on a composite endpoint of all-cause mortality and non-fatal stroke after isolated CABG and assessed POAF duration and timing, AF recurrence, and other predictors of adverse outcomes. Methods: This multicentre retrospective study enrolled 1139 patients who underwent CR after isolated CABG between 2011 and 2015 across 17 Italian centres. Clinical and outcome data were obtained from medical records and structured interviews; median follow-up was 5.78 years. Results: POAF occurred in 34.3% of patients and was associated with a higher incidence of the primary composite endpoint of all-cause mortality and non-fatal stroke in univariate analysis (15.4% vs. 10.0%, p = 0.008), particularly when lasting \u226548 h or occurring during both surgery and rehabilitation. However, in multivariate analysis POAF was not an independent predictor; instead, CHA2DS2-VASc score \u22653, reduced left ventricular ejection fraction, elevated urea, history of heart failure, and AF recurrence during follow-up predicted adverse outcomes. Conclusions: POAF reflects early vulnerability but does not independently predict long-term mortality or stroke. Conversely, AF recurrence and CHA2DS2-VASc score retain strong prognostic value, underscoring the need for long-term rhythm monitoring and individualised risk assessment post-CABG.<\/jats:p>","DOI":"10.3390\/jcm15197577","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:14:37Z","timestamp":1790694877000},"page":"7577","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thromboembolic and Mortality Risk in Patients with Postoperative Atrial Fibrillation After Coronary Artery Bypass Graft\u2014The TRIP-AF Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Roberto F. E.","family":"Pedretti","sequence":"first","affiliation":[{"name":"School of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, MI, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4616-9300","authenticated-orcid":false,"given":"Lucio","family":"Addeo","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical 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Arrhythm."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/S0002-9343(98)00198-3","article-title":"Prospective evaluation of an index for predicting the risk of major bleeding in outpatients treated with warfarin","volume":"105","author":"Beyth","year":"1998","journal-title":"Am. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.jacc.2007.10.043","article-title":"Mechanisms, prevention, and treatment of atrial fibrillation after cardiac surgery","volume":"51","author":"Echahidi","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1056\/NEJMoa1602002","article-title":"Rate control versus rhythm control for atrial fibrillation after cardiac surgery","volume":"374","author":"Gillinov","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1093\/eurheartj\/ehad019","article-title":"Postoperative atrial fibrillation: From mechanisms to treatment","volume":"44","author":"Gaudino","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1161\/CIRCULATIONAHA.120.046940","article-title":"Postoperative atrial fibrillation and long-term risk of stroke after isolated coronary artery bypass graft surgery","volume":"142","author":"Benedetto","year":"2020","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1161\/STROKEAHA.118.023921","article-title":"Perioperative\/postoperative atrial fibrillation and risk of subsequent stroke and\/or mortality","volume":"50","author":"Lin","year":"2019","journal-title":"Stroke"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e007437","DOI":"10.1161\/CIRCEP.119.007437","article-title":"Major adverse cardiovascular events associated with postoperative atrial fibrillation after noncardiac surgery: A systematic review and meta-analysis","volume":"13","author":"AlTurki","year":"2020","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2971","DOI":"10.1093\/eurheartj\/ehac285","article-title":"Post-operative atrial fibrillation and risk of heart failure hospitalization","volume":"43","author":"Goyal","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.athoracsur.2020.05.104","article-title":"Postoperative atrial fibrillation after cardiac surgery: A systematic review and meta-analysis","volume":"111","author":"Eikelboom","year":"2021","journal-title":"Ann. Thorac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e017966","DOI":"10.1161\/JAHA.120.017966","article-title":"New-onset atrial fibrillation after coronary artery bypass grafting and long-term outcome: A population-based nationwide study from the SWEDEHEART registry","volume":"10","author":"Taha","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1001\/jama.291.14.1720","article-title":"A multicenter risk index for atrial fibrillation after cardiac surgery","volume":"291","author":"Mathew","year":"2004","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.ejim.2020.12.018","article-title":"Long-term outcomes of postoperative atrial fibrillation following non-cardiac surgery: A systematic review and meta-analysis","volume":"85","author":"Albini","year":"2021","journal-title":"Eur. J. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1016\/j.athoracsur.2016.05.016","article-title":"Duration of postoperative atrial fibrillation after cardiac surgery is associated with worsened long-term survival","volume":"102","author":"Sigurdsson","year":"2016","journal-title":"Ann. Thorac. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"132529","DOI":"10.1016\/j.ijcard.2024.132529","article-title":"CHA2DS2-VASc predicts readmission, outcomes and resource utilization in patients undergoing coronary artery bypass grafting: A 7-year National Readmission Database study","volume":"417","author":"Wafa","year":"2024","journal-title":"Int. J. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Li, B., Li, J., Meng, X., Yang, S., Tian, F., Song, X., and Liu, J. (2024). The association of blood urea nitrogen-to-creatinine ratio and in-hospital mortality in acute ischemic stroke patients with atrial fibrillation: Data from the MIMIC-IV database. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1331626"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Chen, L., Huang, Z., Zhao, X., Liang, J., Lu, X., He, Y., Kang, Y., Xie, Y., Liu, J., and Liu, Y. (2022). Predictors and mortality for worsening left ventricular ejection fraction in patients with HFpEF. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.820178"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2920","DOI":"10.1161\/01.CIR.0000072767.89944.6E","article-title":"Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: The Framingham Heart Study","volume":"107","author":"Wang","year":"2003","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Rienstra","year":"2024","journal-title":"Eur. Heart J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7577\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:30:16Z","timestamp":1790695816000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7577"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":19,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197577"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197577","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]}}}