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In Reply: We agree with Dr Auer and colleagues that many prior studies do not discriminate whether AF precedes or follows postoperative complications. Our study, however, was designed to address such concerns in that the onset of both AF and postoperative complications were assessed daily, allowing for examination of the temporal relationship between AF and only those complications occurring after onset of AF. We excluded complications that preceded onset of AF. Therefore, we are confident that AF after CABG surgery is associated with greater risk of infectious, renal, and neurologic complications. Moreover, we found that patients with recurrent episodes of AF are at greater risk for these complications than those with a single episode.

We also agree with Auer et al that a strong association between postoperative atrial fibrillation and stroke is lacking in most recently published studies. Similarly, we found that the risk of stroke was not different between . . . [Full Text of this Article]

Joseph P. Mathew, MD
mathe014@mc.duke.edu
Multicenter Study of Perioperative Ischemia Research Group and Department of Anesthesiology
Duke University Medical Center
Durham, NC

Manuel L. Fontes, MD
Multicenter Study of Perioperative Ischemia Research Group and Department of Anesthesiology
Weill Medical College of Cornell University
New York, NY

Dennis T. Mangano, PhD, MD
Multicenter Study of Perioperative Ischemia Research Group and Ischemia Research and Education Foundation
San Francisco, Calif

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