Clinical features and in-hospital mortality associated with different types of atrial fibrillation in patients with acute coronary syndrome with and without ST elevation

González‐Pacheco, Héctor; Márquez, Manlio F.; Arias-Mendoza, Alexandra; Álvarez-Sangabriel, Amada; Eid-Lidt, Guering; González-Hermosillo, Antonio; Azar-Manzur, Francisco; Altamirano-Castillo, Alfredo; Briseño-Cruz, José Luis; García-Martínez, Adolfo; Mendoza-García, Salvador; Martínez‐Sánchez, Carlos

doi:10.1016/j.jjcc.2014.11.001

Cited by 53 publications

(45 citation statements)

References 33 publications

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“…Our study may have underestimated the true AF incidence, as the diagnosis of AF was usually based on a routine ECG and shorter, less symptomatic AF episodes might have been missed; however, it reflects a real‐world practice. Preexisting AF and new‐onset AF might be associated with a different mortality risk among patients with ACS . An important limitation of the current analysis is the lack of data regarding AF status prior to hospitalization; thus, we could not know if the presence of AF during the hospitalization is of new onset.…”

Section: Discussionmentioning

confidence: 97%

Temporal trends and outcomes associated with atrial fibrillation observed during acute coronary syndrome: Real‐world data from the Acute Coronary Syndrome Israeli Survey (ACSIS), 2000–2013

Erez

Goldenberg

Sabbag

et al. 2016

Clinical Cardiology

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Background The past decade has brought major advances in therapy of patients presenting with acute coronary syndromes (ACS). Hypothesis The outcomes of ACS patients with atrial fibrillation (AF) has improved over the years. Methods We evaluated time‐dependent changes in clinical characteristics, management strategies, and outcomes associated with AF observed during ACS hospitalization in patients enrolled in the biannual ACS Israeli Surveys (ACSIS) between 2000 and 2013. We divided the surveys into early (2000–2006) and late (2008–2013) time periods. Results The study population comprised 13 297 ACS patients, of whom 755 (5.7%) either presented with or developed AF during the index hospitalization. The incidence of AF observed during ACS hospitalization was lower during the later period (6.2% vs 4.9%; P < 0.01). Kaplan‐Meier survival analysis showed that 1‐year mortality rates were significantly lower among ACS patients with and without AF who were enrolled during the later vs early survey period (log‐rank P < 0.01 for the overall difference). However, AF observed among ACS patients was still associated with increased risk for in‐hospital complications and 30‐day and 1‐year mortality during both the early and late survey periods (P < 0.05 for all comparisons). Conclusions In 10 years, rates of AF among ACS patients have declined significantly. Yet, despite improved overall 1‐year survival for patients with AF, the development of AF in this population remains an independent predictor of mortality that has not changed appreciably over the years.

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Section: Discussionmentioning

confidence: 97%

Temporal trends and outcomes associated with atrial fibrillation observed during acute coronary syndrome: Real‐world data from the Acute Coronary Syndrome Israeli Survey (ACSIS), 2000–2013

Erez

Goldenberg

Sabbag

et al. 2016

Clinical Cardiology

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“…Additional data on the efficacy of rivaroxaban in patients with PAD will be provided by the phase III VOYAGER PAD trial (NCT02504216) in patients with PAD who have undergone recent procedures to improve peripheral blood flow. Patients with AF and CAD and those undergoing PCI Acute coronary syndrome is commonly associated with prevalent or incident AF, with an incidence of AF in ACS of 2.3-21% [115]. Concomitant AF and ACS increases mortality by 40% versus ACS alone [116][117][118].…”

Section: Coronary and Peripheral Artery Diseasementioning

confidence: 99%

Oral anticoagulant use in cardiovascular disorders: a perspective on present and potential indications for rivaroxaban

Camm

Fox

2018

Current Medical Research and Opinion

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“…Возникновение ФП чаще сопровождает ОКС c подъемом сегмента ST (ОКСпST), чем ОКС без подъема сегмента ST (ОКСбпST) [5,9,10], но в ряде случаев эта связь не наблюдается [11].…”

Section: New-onset Atrial Fibrillation In Acs впервые возникшая фибриunclassified

“…В ряде проводимых исследований уделяют боль-шое внимание времени развития ФП относительно ОКС [5,9,13,38].…”

Section: прогностическое влияние фп в условиях оксunclassified

New-Onset Atrial Fibrillation in Settings of Acute Coronary Syndrome. Current Issues

Galjautdinov

Gorelkin

Ibragimova

et al. 2018

Racionalʹnaâ farmakoterapiâ v kardiologii

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451Настоящий обзор посвящен теме впервые возникшей фибрилляции предсердий (ФП) в условиях острого коронарного синдрома (ОКС). Использованы источники литературы баз PubMed, Scopus. ФП часто встречается в общей популяции и в популяции ОКС, при этом выделяют впервые возникшую ФП, и ФП, бывшую на момент развития ОКС. У пожилых пациентов с хронической сердечной недостаточностью, явле-ниями гемодинамической нестабильности и дилатацией левого предсердия возникновение ее более вероятно. Хорошо известно о предик-торах неблагоприятного исхода ОКС. Согласно некоторым данным, впервые возникшая ФП приводит к ухудшению прогноза, по другим данным причина ее сочетания с высоким уровнем летальности обусловлена тяжестью протекания ОКС, и возникновение ее не является не-зависимым предиктором смерти. Отсутствие субъективных симптомов во время пароксизма ФП не позволяет оценить его продолжительность, и тем самым дифференцировать впервые возникший пароксизм и постоянную или персистирующую форму ФП. Удается проследить связь между ишемией миокарда и возникновением ФП. Неэффективная реперфузия во время проведения чрескожного коронарного вмеша-тельства или тромболитической терапии сопровождается возникновением фибрилляции предсердий, напротив, при достижении эффек-тивной проходимости сосуда она возникает реже. Впервые возникшая при ОКС, и, в частности, сопровождающаяся кардиогенным шоком, ФП требует экстренной кардиоверсии: медикаментозной или электроимпульсной. В ряде случаев проведение активной кардиоверсии не требуется, поскольку восстановление синусового ритма происходит спонтанно. Неоднозначность и многофакторность данной проблемы указывает на необходимость более детального понимания механизмов аритмогенеза и разработки инструментов для стратификации рисков возникновения ФП при ОКС.Ключевые слова: фибрилляция предсердий, острый коронарный синдром, левое предсердие, асимптомная фибрилляция предсердий, чрескожное коронарное вмешательство, кардиоэмболический инсульт. The present review is focuses on new onset atrial fibrillation (AF) in conditions of acute coronary syndrome (ACS). Literature sources from PubMed and Scopus was used. AF is common in the general population and in the ACS population, at that new onset AF, and AF, which was by the time of ACS development are determined. Appearance of AF is more likely amongst the elderly patients with congestive heart failure, with signs of the hemodynamic instability and with the left atrium dilatation. It is well-known about the predictors of adverse outcome in ACS. According to some literature data new onset AF leads to worsening of prognosis, and in line with other sources a reason of its association with high level of mortality is due to the severity of ACS and appearance of AF is not independent predictor of death. The absence of subjective symptoms at the time of paroxysm of new onset AF does not allow estimating its duration and distinguishing between the new onset AF, persistent and constant AF. It is possible to trace the relationship between the myocardial ischemia and AF appeara...

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Clinical features and in-hospital mortality associated with different types of atrial fibrillation in patients with acute coronary syndrome with and without ST elevation

Abstract: Among the different types of AF in patients with ACS, only the new-onset AF that developed during the CCU stay in patients with NSTE-ACS was associated with a 4.40-fold increase in the in-hospital mortality risk.

Cited by 53 publications

References 33 publications

Temporal trends and outcomes associated with atrial fibrillation observed during acute coronary syndrome: Real‐world data from the Acute Coronary Syndrome Israeli Survey (ACSIS), 2000–2013

Temporal trends and outcomes associated with atrial fibrillation observed during acute coronary syndrome: Real‐world data from the Acute Coronary Syndrome Israeli Survey (ACSIS), 2000–2013

Oral anticoagulant use in cardiovascular disorders: a perspective on present and potential indications for rivaroxaban

New-Onset Atrial Fibrillation in Settings of Acute Coronary Syndrome. Current Issues

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