The significance of new onset atrial fibrillation complicating acute myocardial infarction

Oren Zusman, Guy Amit, Harel Gilutz, Doron Zahger

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Background: Atrial fibrillation (AF) in the setting of acute myocardial infarction (AMI) independently predicts in-hospital and long-term morbidity and mortality. Very little data exist regarding the prognostic significance and management of new-onset AF in this setting in the era of dual anti-platelet therapy. Methods: We identified all patients admitted to our coronary care unit for AMI between 2002 and 2009 who developed new-onset AF. The control group was an age and gender matched group of AMI patients who did not have AF. Management and recurrent AF, non-fatal stroke, and mortality data were collected from subsequent hospitalizations and outpatient records. Results: Of 1,991 AMI admissions, new-onset AF was diagnosed in 100 (4.1%). Patients' age was 70 (±12), 32% were female, 58% had ST-elevation AMI and 53% had moderate or worse systolic dysfunction. AF recurred during index admission in 33%. During mean follow-up of 41 months, AF recurred in 22 and 4.5%, and non-fatal stroke occurred in 13 and 1% of the AF and control groups, respectively (p < 0.01 for both). The composite of death and non-fatal stroke was also significantly higher in the AF group, 39 versus 29% (p = 0.02). Oral anti-coagulation was used in only 24% of the AF group and was a significant predictor of stroke-free survival (p = 0.04). Conclusions: New onset AF in the AMI setting carries a substantial future risk for stroke and should not be regarded as a benign, transient complication of the acute event. Long term anticoagulation is underused and is associated with improved stroke-free survival.

Original languageEnglish
Pages (from-to)17-22
Number of pages6
JournalClinical Research in Cardiology
Volume101
Issue number1
DOIs
StatePublished - 1 Jan 2012
Externally publishedYes

Keywords

  • Anticoagulation
  • Atrial fibrillation
  • Myocardial infarction
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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