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Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without

R D Lopes1, K S Pieper, J R Horton

  • 1Duke Clinical Research Institute, Duke University Medical Center, 2400 Pratt Street, Room 0311 Terrace Level, Durham, NC 27707, USA.

Heart (British Cardiac Society)
|March 12, 2008
PubMed

Insights

Atrial fibrillation (AF) is more common in ST-segment elevation myocardial infarction (STEMI) patients. AF is associated with increased short- and long-term mortality in both STEMI and non-ST-segment elevation acute coronary syndromes (NSTE-ACS).

Area of Science:

  • Cardiology
  • Clinical Research
  • Epidemiology

Background:

  • Atrial fibrillation (AF) is a common arrhythmia.
  • Acute coronary syndromes (ACS) encompass ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (NSTE-ACS).
  • The relationship between AF and outcomes in ACS patients requires further investigation.

Purpose of the Study:

  • To determine factors associated with AF occurrence in ACS patients.
  • To evaluate the impact of AF on short- and long-term mortality in ACS patients.
  • To assess AF's association with in-hospital complications in STEMI and NSTE-ACS.

Main Methods:

  • Analysis of a pooled database of 120,566 patients from 10 clinical trials.
  • Utilized multivariable logistic regression and Cox proportional hazards modeling.
  • Investigated patients with STEMI and NSTE-ACS, with and without AF.

Main Results:

  • AF occurred in 7.5% of the overall ACS population (8.0% in STEMI, 6.4% in NSTE-ACS).
  • AF was significantly associated with increased 7-day and long-term mortality in both STEMI and NSTE-ACS patients.
  • AF demonstrated a greater impact on short-term mortality, stroke, and bleeding risk in NSTE-ACS patients.

Conclusions:

  • AF is more prevalent in STEMI patients compared to NSTE-ACS.
  • AF is independently associated with elevated short- and long-term mortality in patients with ACS.
  • Understanding these associations can guide improved patient care and management strategies for AF in ACS.
Abstract

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