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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Atrial fibrillation and clinical outcomes 1 to 3 years after myocardial infarction

Anthony P Carnicelli1, Ruth Owen2, Stuart J Pocock3

  • 1Duke University Hospital, Durham, North Carolina, USA.

Open Heart
|December 16, 2021
PubMed

Insights

Patients with atrial fibrillation (AF) after myocardial infarction (MI) experience poorer quality of life and increased hospitalization risk. Many with AF post-MI remain undertreated with oral anticoagulants, despite high stroke risk.

Area of Science:

  • Cardiology
  • Clinical Research
  • Public Health

Background:

  • Atrial fibrillation (AF) and myocardial infarction (MI) frequently coexist and are linked to adverse health outcomes.
  • The impact of AF on the quality of life and prognosis for patients following MI is not well understood.

Purpose of the Study:

  • To compare the characteristics, quality of life, and clinical outcomes of stable patients post-MI with and without AF.
  • To identify potential gaps in the management of oral anticoagulation in patients with AF post-MI.

Main Methods:

  • Analysis of data from the prospective, international, observational TIGRIS registry, including 8406 patients 1-3 years post-MI.
  • Assessment of quality of life using EQ-5D at baseline and clinical outcomes over 2 years of follow-up.
  • Multivariable adjustment to compare outcomes between patients with and without AF.

Main Results:

  • AF was present in 8.5% of patients; these patients were older with more comorbidities.
  • Patients with AF reported significantly lower quality of life scores (EQ-5D index, VAS, usual activities, pain/discomfort).
  • Despite high CHA2DS2-VASc scores, less than half of AF patients were on oral anticoagulants; they experienced higher all-cause hospitalization rates (aRR 1.25) but similar mortality.

Conclusions:

  • Stable patients post-MI with AF exhibit poorer quality of life and an elevated risk of clinical events compared to those without AF.
  • A significant proportion of patients with AF post-MI are undertreated with oral anticoagulants, indicating a need for improved management strategies.
Abstract

Keywords:
atrial fibrillationhealth servicesmyocardial infarctionstroke

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