• Rev Esp Cardiol (Engl Ed) · Jan 2015

    Observational Study

    Short- and long-term prognosis of previous and new-onset atrial fibrillation in ST-segment elevation acute myocardial infarction.

    • Luciano Consuegra-Sánchez, Antonio Melgarejo-Moreno, José Galcerá-Tomás, Nuria Alonso-Fernández, Ángela Díaz-Pastor, Germán Escudero-García, Leticia Jaulent-Huertas, and Marta Vicente-Gilabert.
    • Servicio de Cardiología, Hospital General Universitario de Santa Lucía, Cartagena, Murcia, Spain. Electronic address: lconsue@gmail.com.
    • Rev Esp Cardiol (Engl Ed). 2015 Jan 1; 68 (1): 31-8.

    Introduction And ObjectivesThe impact of atrial fibrillation on the prognosis of myocardial infarction is still the subject of debate. We analyzed the influence of previous and new-onset atrial fibrillation on in-hospital and long-term prognosis in patients with acute myocardial infarction.MethodsProspective study of 4284 patients with ST-segment elevation acute myocardial infarction. We studied all-cause in-hospital and long-term mortality (median, 7.2 years) using adjusted models.ResultsIn total, 3.2% of patients had previous atrial fibrillation and 9.8% had new-onset atrial fibrillation. In general, both groups of patients had a high baseline risk profile and an increased likelihood of in-hospital complications. The crude in-hospital mortality rate was higher in patients with previous atrial fibrillation than in those with new-onset atrial fibrillation (22% vs 12%; P<.001; 30% vs 10%; P<.001). The long-term mortality rate was 11.11/100 patient-years in patients with previous atrial fibrillation and 5.35/100 patient years in those with new-onset atrial fibrillation (both groups, P<.001). New-onset fibrillation alone (odds ratio=1.55; 95% confidence interval, 1.08-2.22) was an independent predictor of in-hospital mortality. Previous atrial fibrillation (hazard ratio=1.24; 95% confidence interval, 0.94-1.64) and new-onset atrial fibrillation (hazard ratio=0.98; 95% confidence interval, 0.80-1.21) were not independent predictors of long-term mortality.ConclusionsNew-onset atrial fibrillation during hospitalization is an independent risk factor for in-hospital mortality in acute myocardial infarction.Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

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