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The bidirectional association between atrial fibrillation and myocardial infarction

Tanja Charlotte Frederiksen1,2, Christina Catherine Dahm3, Sarah R Preis4

  • 1Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

Nature Reviews. Cardiology
|April 17, 2023
PubMed

Insights

Atrial fibrillation (AF) and myocardial infarction (MI) share risk factors and mechanisms, increasing risks for both conditions. Managing AF and MI together is crucial to reduce adverse outcomes like stroke and heart failure.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Pathophysiology

Background:

  • Atrial fibrillation (AF) and myocardial infarction (MI) share a complex bidirectional relationship.
  • This association is driven by common risk factors and direct/indirect pathophysiological mechanisms.

Purpose of the Study:

  • To review the bidirectional association between AF and MI.
  • To discuss the underlying pathogenic mechanisms and clinical implications.
  • To summarize current management strategies and identify research gaps.

Main Methods:

  • Literature review of existing studies and guidelines.
  • Analysis of shared risk factors and pathophysiological pathways.
  • Synthesis of data on clinical outcomes and management.

Main Results:

  • AF and MI exhibit a bidirectional relationship mediated by inflammation, ischemia, and embolism.
  • Coexistence of AF and MI significantly elevates risks of stroke, heart failure, and mortality.
  • Current guidelines address prevention and management, but gaps remain.

Conclusions:

  • Understanding the interplay between AF and MI is critical for patient outcomes.
  • Integrated management strategies are essential for patients with both conditions.
  • Further research is needed to elucidate mechanisms and optimize treatment.

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