Pre-existing (AF) is independently associated with adverse postoperative outcomes following noncardiac surgery in older adults, according to a study published the Journal of the American College of Cardiology. Sameer Prasada, MD, and colleagues assessed the impact of AF on the risk for adverse outcomes after noncardiac surgery. The analysis included a national sample of 8.6 million Medicare beneficiaries who underwent noncardiac surgery (vascular, thoracic, general, genitourinary, gynecologic, orthopedic and neurosurgery, breast, head and neck, and transplant) from 2015-2019 (16.4 % with AF). In a propensity-matched analysis, AF was associated with a higher risk for mortality (OR, 1.31), heart failure (OR, 1.31), and stroke (OR, 1.40), as well as a lower risk for myocardial infarction (OR, 0.81). In a subgroup analysis by sex, race, surgery type, and all strata of the revised cardiac risk index and CHA2DS2-VASc score, results were similar. The discriminative ability of the revised cardiac risk index was improved with the addition of AF.