Long‐term impact of new‐onset atrial fibrillation complicating acute myocardial infarction on heart failure

Luo, Jiachen; Xu, Siling; Li, Hongqiang; Li, Zhiqiang; Liu, Baoxin; Qin, Xiaoming; Gong, Mengmeng; Shi, Bingjie; Wei, Yidong

doi:10.1002/ehf2.12872

Cited by 19 publications

(23 citation statements)

References 29 publications

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“…In addition, CHADs and CHADs-VASc scores, which are used to predict thromboembolic events in patients with AF, have been recently investigated for their effects on mortality in ACS. The CHADs-VASc score especially has been reported to predict in-hospital and long-term mortality in patients with ACS (14,15). The CHADs-VASc score also was found to be an important predictor of in-hospital mortality in our study.…”

Section: Discussionsupporting

confidence: 71%

Incidence of atrial fibrillation and its effects on long-term follow-up outcomes in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction

Arslan

Batıt

Kılıçarslan

et al. 2021

Anatolian J Cardiol

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Objective: The incidence of atrial fibrillation (AF) in patients with ST segment elevation myocardial infarction (STEMI) varies between 7% and 21%, and most of these studies were in the thrombolytic era. However, the frequency of new-onset AF during the primary percutaneous coronary intervention (PCI) period is still unclear. We aimed to investigate the frequency of new-onset AF and its effects on long-term clinical events in patients undergoing primary PCI. Methods: A total of 1,603 patients who were diagnosed with STEMI and underwent primary PCI were included in the study. All the patients were monitored for at least 48 hours after the procedure. The primary endpoint of the study was defined as new-onset AF during hospitalization. Results: The median follow-up period of our study was 44 months. New-onset AF developed in 85 (6.1%) patients. CHADs-VASc > 2, KILLIP > 2, and left atrial diameter were found to be independent predictors for the development of new-onset AF. In the AF (+) group, the all-cause and in-hospital mortality rates were found to be significantly higher. New-onset AF development in patients with STEMI was detected as an independent predictor of in-hospital mortality. Conclusion:In the era of primary percutaneous transluminal coronary angioplasty, new-onset AF rates were found to be lower than the literature data. In addition, new-onset AF was found to be a predictor of in-hospital mortality, and deaths occurred mostly in the early period. Therefore, close follow-up of these patients in the early period and re-evaluation in terms of AF burden when the patient becomes stable are important.

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Section: Discussionsupporting

confidence: 71%

Incidence of atrial fibrillation and its effects on long-term follow-up outcomes in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction

Arslan

Batıt

Kılıçarslan

et al. 2021

Anatolian J Cardiol

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“…The design of the NOAFCAMI-SH registry has been previously described ( 16 , 17 ). In brief, this is a retrospective cohort study from a tertiary academic medical center, which included patients who experienced an AMI, did not have a medical history of AF, and received continuous electronic monitoring (CEM) during hospitalization between February 2014 and March 2018.…”

Section: Methodsmentioning

confidence: 99%

Prognostic Impact of the Symptom of New-Onset Atrial Fibrillation in Acute Myocardial Infarction: Insights From the NOAFCAMI-SH Registry

Luo

Liu

et al. 2021

Front. Cardiovasc. Med.

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Background: New-onset atrial fibrillation (NOAF) is a common complication during acute myocardial infarction (AMI) and sometimes can be completely asymptomatic, but the clinical implications of these asymptomatic episodes require further characterization. The objective of this study was to investigate the short- and long-term prognostic impact of post-MI NOAF based on the presence of AF-related symptoms.Methods: The New-Onset Atrial Fibrillation Complicating Acute Myocardial Infarction in ShangHai (NOAFCAMI-SH) registry was a retrospective cohort including participants with AMI without a documented history of AF. Patients with NOAF were divided into two groups according to the AF-related symptoms. The primary endpoint was all-cause mortality.Results: Of 2,399 patients included, 278 (11.6%) developed NOAF of whom 145 (6.0%) with asymptomatic episodes and 133 (5.5%) with symptomatic ones. During hospitalization, 148 patients died [106, 10, and 32 in the sinus rhythm (SR), asymptomatic, and symptomatic NOAF groups, respectively]. After multivariable adjustment, only symptomatic NOAF was associated with in-hospital mortality [odds ratio (OR): 2.32, 95% confidence interval (CI): 1.36–3.94] compared with SR. Over a median follow-up of 2.7 years, all-cause mortality was 3.2, 12.4, and 11.8% per year in the SR, asymptomatic, and symptomatic NOAF groups, respectively. After adjustment for confounders, it was the asymptomatic NOAF [hazard ratio (HR): 1.61, 95% CI: 1.09–2.37) rather than the symptomatic one (HR: 1.37, 95% CI: 0.88–2.12) that was significantly related to mortality. Similar results were also observed for cardiovascular mortality [HRs and 95% CI were 1.71 (1.10–2.67) and 1.25 (0.74–2.11) for asymptomatic and symptomatic NOAF, respectively]. Both asymptomatic and symptomatic NOAF episodes were associated with heart failure, whereas only those with symptomatic NOAF were at heightened risk of ischemic stroke. Our exploratory analysis further identified patients with asymptomatic high-burden NOAF as the highest-risk population (mortality: 19.6% per year).Conclusion: Among patients with AMI, symptomatic NOAF is related to in-hospital mortality and asymptomatic NOAF is associated with poor long-term survival.Registration: URL: https://clinicaltrials.gov/; Unique identifier: NCT03533543.

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“… 5 , 6 Accounting for the detrimental impact of NOAF, numerous preceding studies have been conducted to identify the risk factors of post-MI NOAF, since adequate management of these risk factors may be helpful in reducing the incidence of NOAF and improving patients’ prognosis. 4 , 7 …”

Section: Introductionmentioning

confidence: 99%

“…HF, particularly for that with a reduced ejection fraction (HFrEF) (left ventricular ejection fraction [LVEF] <40%), has generally been perceived as an independent risk factor of post-MI NOAF. 4 , 7 , 8 Due to the advances in pharmacotherapies and interventional treatments, the incidence of post-MI HFrEF has declined over the past decades, whereas that of HF with preserved ejection fraction (HFpEF) (LVEF ≥50%) and mid-range ejection fraction (HFmrEF) (LVEF 40~49%) gradually increased. 9 , 10 Thereafter, a number of studies have investigated the impact of AF on the prognosis of HF individuals stratified by LVEF levels while yielding conflicting results.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of New-Onset Atrial Fibrillation in Heart Failure with Preserved, Mid-Range, and Reduced Ejection Fraction Following Acute Myocardial Infarction: Data from the NOAFCAMI-SH Registry

Hao¹,

Luo²,

Liu³

et al. 2022

CIA

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Purpose The prognostic impact of new-onset atrial fibrillation (NOAF) among different heart failure (HF) subtypes including HF with preserved (HFpEF, ejection fraction [EF] ≥50%), mid-range (HFmrEF, EF 40%~49%), and reduced (HFrEF, EF <40%) EF following acute myocardial infarction (AMI) remains unclear. We aimed to investigate the incidence and prognostic implication of post-MI NOAF across HF subtypes. Patients and Methods We included 1413 patients with post-MI HF (743 with HFpEF, 342 with HFmrEF and 328 with HFrEF) between February 2014 and March 2018. NOAF was considered as patients without a preexisting AF who developed AF during the AMI hospitalization. The primary endpoint was all-cause mortality. Results Of 1413 patients (mean age 66.8 ± 12.6 years, 72.9% men) analyzed, 200 (14.2%) developed post-MI NOAF. Patients with HFrEF were more likely to experience NOAF compared to those with HFmrEF or HFrEF (18.9%, 13.7% and 12.2% in HFrEF, HFmrEF and HFpEF, respectively; p for trend = 0.006). During a median follow-up of 28.5 months, 192 patients died (70 with HFrEF, 35 with HFmrEF and 87 with HFpEF) and 195 patients experienced HF rehospitalization (79 with HFrEF, 37 with HFmrEF and 79 with HFpEF). After multivariable adjustment, NOAF was independently associated with all-cause mortality (hazard ratio [HR]: 1.79, 95% confidence interval [CI]: 1.03–3.12) only in the HFrEF group compared to sinus rhythm (SR), whereas an increased risk of HF rehospitalization was found in all HF subtypes, particularly in HFmrEF (HR: 5.08, 95% CI: 2.29–11.25) and HFpEF (HR: 2.83 95% CI: 1.64–4.90). Conclusion In patients with post-MI HF, NOAF carried a worse prognosis for all-cause death in the HFrEF group and for HF rehospitalization in all HF subtypes.

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Long‐term impact of new‐onset atrial fibrillation complicating acute myocardial infarction on heart failure

Cited by 19 publications

References 29 publications

Incidence of atrial fibrillation and its effects on long-term follow-up outcomes in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction

Incidence of atrial fibrillation and its effects on long-term follow-up outcomes in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction

Prognostic Impact of the Symptom of New-Onset Atrial Fibrillation in Acute Myocardial Infarction: Insights From the NOAFCAMI-SH Registry

Prognostic Significance of New-Onset Atrial Fibrillation in Heart Failure with Preserved, Mid-Range, and Reduced Ejection Fraction Following Acute Myocardial Infarction: Data from the NOAFCAMI-SH Registry

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