Influence of Atrial Fibrillation on Outcomes in Patients Who Underwent Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

Garg, Lohit; Agrawal, Sahil; Agarwal, Manyoo; Shah, Mahek; Garg, Aakash; Patel, Brijesh; Agarwal, Nayan; Nanda, Sudip; Sharma, Abhishek; Cox, David A.

doi:10.1016/j.amjcard.2017.12.003

Cited by 25 publications

(25 citation statements)

References 25 publications

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“…Previous studies reported a prevalence of AF varying from 8.7% 19 to 19% 18 in the Coronary Artery Disease (CAD) spectrum. Our study findings were in agreement regarding AF prevalence.…”

Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation: A Novel Risk Factor for No-Reflow Following Primary Percutaneous Coronary Intervention

Kaya

Keskin²,

Tatlısu

et al. 2019

Angiology

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There is a lack of evidence regarding the association of atrial fibrillation (AF) and no-reflow (NR) phenomenon in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI). A total of 2452 patients with STEMI who underwent pPCI were retrospectively investigated. After exclusions, 370 (14.6%) patients were in the AF group and 2095 (85.4%) were in the No-AF group. Patients with a thrombolysis in myocardial infarction flow rate <3 were defined as having NR. Patients in the AF group were older and had higher 3-vessel disease rates (24.1% vs 18.9%; P = .021) and lower left ventricular ejection fraction (45.4 [11.7] vs 48.7 [10.5%]; P < .001). No-reflow rates were higher in the AF group than in the No-AF group (29.1% vs 11.8%; P < .001). According to multivariable analysis, AF (odds ratio: 1.81, 95% confidence interval: 1.63-2.04, P < .001), age, Killip class, anterior myocardial infarction, diabetes mellitus, chronic kidney disease, stent length, and smoking were independent predictors of NR following pPCI. Atrial fibrillation is a quite common arrhythmia in patients with STEMI. Atrial fibrillation was found to be an independent predictor of NR in the current study. This effect of AF on coronary flow rate might be considered as an important risk factor in STEMI.

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“…Previous studies reported a prevalence of AF varying from 8.7% 19 to 19% 18 in the Coronary Artery Disease (CAD) spectrum. Our study findings were in agreement regarding AF prevalence.…”

Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation: A Novel Risk Factor for No-Reflow Following Primary Percutaneous Coronary Intervention

Kaya

Keskin²,

Tatlısu

et al. 2019

Angiology

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“…Two large retrospective registries in the USA and South Korea reported AF in 8.7% and 4.3% of the patients' population, respectively. However, neither studies discriminated between prior AF and post-primary PCI NOAF [24,25].…”

Section: The Incidence Of New-onset Afmentioning

confidence: 90%

“…The analysis indicated a higher mortality in patients with AF compared to those without AF (10.3% vs. 9.4%, adjusted OR 1.1, CI 1.06-1.16, p < 0.0001). Higher rates of complications were reported during hospitalization of patients with AF including acute heart failure (33.0%), cardiogenic shock (17.2%), stroke (1.0%), acute kidney injury (12.8%), vascular complications (1.4%), bleeding (4.0%) and blood transfusion (5.0%) [24].…”

Section: Namentioning

confidence: 97%

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New-Onset Atrial Fibrillation in the Post-Primary PCI Setting: A Systematic Review

AL-Obaidi

Al-Kinani

Al-Ali

et al. 2019

Acta Medica Bulgarica

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Background: Atrial fibrillation is a relatively common complication of acute myocardial infarction with significant impact on the short and long-term prognosis. Methods: A systematic literature review was done through Pubmed and CENTRAL to extract data related to new-onset atrial fibrillation following primary PCI. Results: Searching resulted in twenty-one matched studies. Extraction of data showed an incidence rate of new-onset atrial fibrillation (2.8%-58%). A negative impact was found on the outcomes of patients treated with primary PCI with increased short and long-term mortality and morbidity. Conclusion: New-onset atrial fibrillation is an adverse prognostic marker in patients with acute myocardial infarction treated invasively. Preventive measures and anticoagulant therapy should be considered more intensively in this subset of patients.

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“…AF impacts unfavorably on the hemodynamic state, especially in case of high ventricular response rate [5,6], and also increases the risk of in-hospital complications such as bleeding and ischemic and hemorrhagic strokes [3]. Thus, it would be reasonable to deduce that AF has negative impact on patient outcome in ACS [3,5,[7][8][9][10][11][12][13]. However, study results are inconclusive and somewhat controversial in this respect [14][15][16], and there is wide variation in follow-up time from weeks to several years in the different studies [17].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Atrial Fibrillation on the Long-Term Mortality of Patients with Acute Coronary Syndrome: The TACOS Study

et al. 2021

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Introduction: Atrial fibrillation (AF) is a frequent finding in acute coronary syndrome (ACS), but there is conflicting scientific evidence regarding its long-term impact on patient outcome. The aim of this study was to survey and compare the ≥10-year mortality of ACS patients with sinus rhythm (SR) and AF. Methods: Patients were divided into 2 groups based on rhythm in their 12-lead ECGs: (1) SR (n = 788) at hospital admission and discharge (including sinus bradycardia, physiological sinus arrhythmia, and sinus tachycardia) and (2) AF/atrial flutter (n = 245) at both hospital admission and discharge, or SR and AF combination. Patients who failed to match the inclusion criteria were excluded from the final analysis. The main outcome surveyed was long-term all-cause mortality between AF and SR groups during the whole follow-up time. Results: Consecutive ACS patients (n = 1,188, median age 73 years, male/female 58/42%) were included and followed up for ≥10 years. AF patients were older (median age 77 vs. 71 years, p < 0.001) and more often female than SR patients. AF patients more often presented with non-ST-elevation myocardial infarction (69.8 vs. 50.4%, p < 0.001), had a higher rate of diabetes (31.0 vs. 22.8%, p = 0.009), and were more often using warfarin (32.2 vs. 5.1%, p < 0.001) or diuretic medication (55.1 vs. 25.8%, p < 0.001) on admission than patients with SR. The use of warfarin at discharge was also more frequent in the AF group (55.5 vs. 14.8%, p < 0.001). The rates of all-cause and cardiovascular mortality were higher in the AF group (80.9 vs. 50.3%, p < 0.001, and 73.8 vs. 69.6%, p = 0.285, respectively). In multivariable analysis, AF was independently associated with higher mortality when compared to SR (adjusted HR 1.662; 95% CI: 1.387–1.992, p < 0.001). Conclusion: AF/atrial flutter at admission and/or discharge independently predicted poorer long-term outcome in ACS patients, with 66% higher mortality within the ≥10-year follow-up time when compared to patients with SR.

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Influence of Atrial Fibrillation on Outcomes in Patients Who Underwent Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

Cited by 25 publications

References 25 publications

Atrial Fibrillation: A Novel Risk Factor for No-Reflow Following Primary Percutaneous Coronary Intervention

Atrial Fibrillation: A Novel Risk Factor for No-Reflow Following Primary Percutaneous Coronary Intervention

New-Onset Atrial Fibrillation in the Post-Primary PCI Setting: A Systematic Review

The Effect of Atrial Fibrillation on the Long-Term Mortality of Patients with Acute Coronary Syndrome: The TACOS Study

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