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Published on: February 26, 2013
Atrial Fibrillation and Risk of ST-Segment-Elevation Versus Non-ST-Segment-Elevation Myocardial Infarction: The
Elsayed Z Soliman1, Faye Lopez2, Wesley T O'Neal2
1From Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention (E.Z.S., Z.-M.Z.), Department of Internal Medicine, Section on Cardiology (E.Z.S.), and Department of Internal Medicine (W.T.O.), Wake Forest School of Medicine, Winston Salem, NC; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (F.L., L.B., A.A.); Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis (L.Y.C.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (L.L.); and Department of Medicine, University of Vermont, Burlington (M.C.). esoliman@wakehealth.edu.
Atrial fibrillation (AF) increases myocardial infarction (MI) risk, particularly non-ST-segment-elevation MI (NSTEMI), especially in women. This finding highlights potential sex differences in cardiovascular disease mechanisms.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Atrial fibrillation (AF) is linked to a higher risk of myocardial infarction (MI).
- The underlying mechanisms for this association remain unclear.
- Investigating the relationship between AF and specific MI types (STEMI vs. NSTEMI) may offer insights into mechanisms.
Purpose of the Study:
- To examine the association between atrial fibrillation (AF) and incident myocardial infarction (MI).
- To determine if this association differs between ST-segment-elevation MI (STEMI) and non-ST-segment-elevation MI (NSTEMI).
- To explore potential sex differences in the AF-MI relationship.
Main Methods:
- Analysis of 14,462 participants from the Atherosclerosis Risk in Communities (ARIC) study, free of coronary heart disease at baseline.
- Follow-up for incident MI and AF identification through ECGs and hospital records over a median of 21.6 years.
- Multivariable-adjusted Cox proportional hazards models were used to assess associations, with interaction analyses for sex differences.
Main Results:
- Atrial fibrillation (AF) was associated with a 63% increased risk of overall MI.
- The association was significant for non-ST-segment-elevation MI (NSTEMI) but not for ST-segment-elevation MI (STEMI).
- The link between AF and MI (total and NSTEMI) was significantly stronger in women than in men.
Conclusions:
- Atrial fibrillation is associated with an elevated risk of incident myocardial infarction.
- This association is specifically linked to non-ST-segment-elevation MI (NSTEMI).
- Women exhibit a stronger association between AF and MI compared to men.
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