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Published on: February 26, 2013
Predictions and Outcomes of Atrial Fibrillation in the Patients with Acute Myocardial Infarction
Mihailo Vukmirović1, Aneta Bošković1, Irena Tomašević Vukmirović2
1Department of Cardiology, Clinical Center of Montenegro, Montenegro, 20000 Podgorica.
Insights
Older age, higher BMI, larger left atrium, mitral regurgitation, and elevated BNP predict hospital-acquired atrial fibrillation (AF) in acute myocardial infarction patients. AF patients showed higher mortality, though not statistically significant in this study.
Area of Science:
- Cardiology
- Epidemiology
- Internal Medicine
Background:
- Atrial fibrillation (AF) is linked to increased mortality and adverse events in acute myocardial infarction (AMI) patients.
- Identifying predictors of new-onset AF during hospitalization for AMI is crucial for risk stratification and management.
Purpose of the Study:
- To determine predictors of new-onset atrial fibrillation during hospitalization in patients with acute myocardial infarction.
- To evaluate the impact of new-onset AF on short- and long-term mortality in AMI patients.
Main Methods:
- Prospective study including 600 patients with acute myocardial infarction.
- Logistic regression analysis to identify predictors of AF development.
- Follow-up of 84 months to assess mortality outcomes.
Main Results:
- New-onset AF developed in 8% of AMI patients during hospitalization.
- Strongest predictors included older age (>70 years), elevated Body Mass Index (BMI), enlarged left atrium diameter, mitral regurgitation, and elevated B-type natriuretic peptide.
- Patients with new-onset AF exhibited higher in-hospital and 84-month mortality rates compared to those without AF, although not statistically significant.
Conclusions:
- Several clinical and echocardiographic factors predict new-onset atrial fibrillation in AMI patients.
- While trends suggest increased mortality with new-onset AF, further research with larger cohorts is needed to establish statistical significance.
Abstract:
The large epidemiological studies demonstrated that atrial fibrillation is correlated with high mortality and adverse events in patients with acute myocardial infarction. The aim of this study was to determinate predictors of atrial fibrillation develop during the hospital period in patients with acute myocardial infarction as well as short- and long-term mortality depending on the atrial fibrillation presentation. The 600 patients with an acute myocardial infarction were included in the study and follow-up 84 months. Atrial fibrillation develops during the hospital period was registered in 48 patients (8%). After adjustment by logistic regression model the strongest predictor of atrial fibrillation develop during the hospital period was older age, particularly more than 70 years (odds ratio 2.37, CI 1.23-4.58, p=0.010), followed by increased of Body Mass Index (odds ratio 1.17, CI 1.04-1.33, p=0.012), enlarged diameter of left atrium (LA) (odds ratio 1,18, CI 1,03-1,33, p=0,015) presentation of mitral regurgitation (odds ratio 3.56, CI 1.25-10.32, p=0.018) and B-type natriuretic peptide (odds ratio 2.12, CI 1.24-3.33, p=0.048).Patients with atrial fibrillation develop during the hospital period had a higher mortality during the hospital course (10.4% vs. 5.6%) p=0.179. as well as follow-up period of 84 months than patients without it (64.6% vs. 39.1%) p=0.569, than patients without it, but without statistically significance. Patients with AF develop during the hospital period had higher mortality during the hospital course as well as follow up period of 84 months than patients without it, but without statistically significance.
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