Long-term prognostic outcomes and implication of oral anticoagulants in patients with new-onset atrial fibrillation following st-segment elevation myocardial infarction

Madsen, Jasmine Melissa; Jacobsen, Mia Ravn; Sabbah, Muhammad; Topal, Divan Gabriel; Jabbari, Reza; Glinge, Charlotte; Køber, Lars; Torp‐Pedersen, Christian; Pedersen, Frants; Sørensen, Rikke; Holmvang, Lene; Engstrøm, Thomas; Lønborg, Jacob

doi:10.1016/j.ahj.2021.04.012

Cited by 15 publications

(24 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that 7.7% of the STEMI patients in our study cohort developed NOAF during hospitalization, consistent with previously reported rates of AF development for similar patient populations (1,2). Prior reports have demonstrated newonset AF after STEMI revascularization is correlated with higher incidence of morbidity, mortality as well as prolonged hospital stay, consistent with the relevance of NOAF as a risk factor associated with greater clinical severity and a worse prognosis (4,6,7,24,25). Consistently, we found that patients in the NOAF group in our study cohort exhibited a longer duration of hospitalization and higher rates of both in-hospital mortality and long-term all-cause mortality as compared to SR patients.…”

Section: Discussionsupporting

confidence: 91%

“…Patients were diagnosed with STEMI as per the European Society of Cardiology standard ( 20 ). Patients were excluded from this analysis if: ( 1 ) they refused to undergo invasive treatment, ( 2 ) they had been admitted over 24 h after the onset of symptoms, ( 3 ) they underwent thrombolytic therapy or emergent coronary artery bypass grafting surgery (CABG), ( 4 ) they exhibited STEMI complicated by severe liver or renal failure or anemia, ( 5 ) they demonstrated background of AF or atrial flutter, ( 6 ) they exhibited hyperthyroidism or heart valve disease defined as valvular regurgitation or stenosis, or ( 7 ) they had any history of PCI or acute myocardial infarction (AMI). In sum, 549 patients were qualified to participate in the present research bases on these criteria ( Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…One of the most frequent complications that affects an estimated 5-11% of ST-segment elevation myocardial infarction (STEMI) cases following percutaneous coronary intervention (PCI) is new-onset atrial fibrillation (NOAF) (1,2). NOAF incidence in this context has been linked to higher rates of morbidity, mortality and prolonged hospitalization, which are largely attributable to the hemodynamic instability and prothromboembolic effects (3)(4)(5)(6)(7). The precise etiological basis of NOAF in STEMI patients following PCI is complex and influenced by a range of risk factors such as aging, female sex, hypertension and heart failure (5,8,9).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Triglyceride-Glucose Index and New-Onset Atrial Fibrillation in ST-Segment Elevation Myocardial Infarction Patients After Percutaneous Coronary Intervention

Yang

Qing

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundNew-onset atrial fibrillation (NOAF) is associated with worse prognostic outcomes in cases diagnosed with ST-segment elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). The triglyceride-glucose (TyG) index, as a credible and convenient marker of insulin resistance, has been shown to be predictive of outcomes for STEMI patients following revascularization. The association between TyG index and NOAF among STEMI patients following PCI, however, has not been established to date.ObjectiveTo assess the utility of the TyG index as a predictor of NOAF incidence in STEMI patients following PCI, and to assess the relationship between NOAF and long-term all-cause mortality.MethodsThis retrospective cohort research enrolled 549 STEMI patients that had undergone PCI, with these patients being clustered into the NOAF group and sinus rhythm (SR) group. The predictive relevance of TyG index was evaluated through logistic regression analyses and the receiver operating characteristic (ROC) curve. Kaplan-Meier curve was employed to explore differences in the long-term all-cause mortality between the NOAF and SR group.ResultsNOAF occurred in 7.7% of the enrolled STEMI patients after PCI. After multivariate logistic regression analysis, the TyG index was found to be an independent predictor of NOAF [odds ratio (OR): 8.884, 95% confidence interval (CI): 1.570–50.265, P = 0.014], with ROC curve analyses further supporting the predictive value of this parameter, which exhibited an area under ROC curve of 0.758 (95% CI: 0.720–0.793, P < 0.001). All-cause mortality rates were greater for patients in the NOAF group in comparison with the SR group over a median 35-month follow-up period (log-rank P = 0.002).ConclusionsThe TyG index exhibits values as an independent predictor of NOAF during hospitalization, which indicated a poorer prognosis after a relatively long-term follow-up.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Triglyceride-Glucose Index and New-Onset Atrial Fibrillation in ST-Segment Elevation Myocardial Infarction Patients After Percutaneous Coronary Intervention

Yang

Qing

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…In the present study, we investigated long-term risk of ischemic stroke associated with post-MI NOAF, and this risk was compared with that of previous AF. Although numerous studies have reported a significant association between increased mortality and post-MI NOAF, clinical data on the risk of ischemic stroke during long-term follow-up are limited, and their results are conflicting [ 6 , 7 , 20 , 21 ]. In our study, post-MI NOAF was an independent predictor of ischemic stroke, along with previous AF.…”

Section: Discussionmentioning

confidence: 99%

“…However, new-onset AF (NOAF) in the setting of ACS has shown different clinical characteristics or prognoses from those of previous AF [ 3 ], and its underlying mechanism remains unclear [ 4 ]. Furthermore, unlike the previous AF that has been relatively well-established as a risk factor for ischemic stroke [ 5 ], the association of NOAF complicating ACS with risk of ischemic stroke is controversial [ 6 , 7 ]. In a recently published meta-analysis, Luo J. et al identified a significantly higher risk of ischemic stroke after ACS in patients with NOAF compared with those in sinus rhythm, but their results were obtained mostly from observational studies that examined in-hospital or short-term outcomes with different definitions of NOAF [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction

Seo

Lim

et al. 2021

JCM

View full text Add to dashboard Cite

Background: Atrial fibrillation (AF) has been identified as a major risk factor for mortality after acute coronary syndrome (ACS). However, the long-term risk of ischemic stroke associated with new-onset atrial fibrillation (NOAF) in ACS remains controversial, and its gender-specific association is unknown. Methods: We analyzed the data of 10,137 ACS survivors included in a multicenter, prospective registry for Korean patients with acute myocardial infarction (AMI) between January 2004 and August 2014. Subjects were categorized into three groups (non-AF vs. NOAF vs. previous AF) based on medical history and electrocardiographic evidence of AF, either at admission or during hospitalization. Results: Among the total study population (72.3% men), 370 patients (3.6%) had NOAF and 130 (1.3%) had previous AF. During a median follow-up of 61 months (interquartile range, 38.8 to 89.3 months), 245 (2.4%) patients (218 (2.3%) non-AF vs. 15 (4.1%) NOAF vs. 12 (9.2%) previous AF, p < 0.001) experienced ischemic stroke. After adjustment for confounding variables, both NOAF (adjusted hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.09–3.24, p = 0.024) and previous AF (adjusted HR 4.00, 95% CI 2.03–7.87, p < 0.001), along with older age, diabetes, current smoker, and previous stroke were independent risk factors of ischemic stroke. In the gender-stratified analysis, men with previous AF but not NOAF had a significantly higher risk of ischemic stroke (adjusted HR 4.14, 95% CI 1.79–9.55, p = 0.001) than those without AF. In women, NOAF (adjusted HR 2.54, 95% CI 1.21–5.35, p = 0.014) as well as previous AF (adjusted HR 3.72, 95% CI 1.16–11.96, p = 0.028) was a strong predictor of ischemic stroke, and the predictive value was comparable to that of previous AF among patients with a CHA2DS2-VASc score ≥ 2. Conclusions: Both NOAF and previous AF were associated with ischemic stroke after AMI, but the impact of NOAF as a risk factor of ischemic stroke was significant only in women.

show abstract

Incidence and predictors of new‐onset atrial fibrillation in ST‐elevation myocardial infarction: A single‐center study

Zarei,

Bozorgi,

Khoshfetrat

et al. 2024

Health Science Reports

View full text Add to dashboard Cite

Background and AimsAtrial fibrillation (AF) is a common arrhythmia that occurs following ST‐elevation myocardial infarction (STEMI) and can significantly impact clinical outcomes. We investigated the incidence and predictors of AF following STEMI in patients, as well as its association with major adverse cardiac and cerebrovascular events (MACCE).MethodsWe conducted a retrospective cohort study, including all STEMI patients who presented under code 247 to Tehran Heart Center between 2016 and 2020 and completed a 1‐year follow‐up. Patients were divided into two groups based on the development of AF during follow‐up, and their baseline and clinical characteristics were compared. We used multivariable regression models to identify predictors of MACCE.ResultsOut of 3647 STEMI patients, 84 (2.3%) developed new‐onset AF (NOAF). Patients with AF were significantly older and had lower levels of total and low‐density lipoprotein cholesterol, triglyceride, and hemoglobin, but higher levels of fasting blood sugar and creatinine. AF patients were also more likely to have a history of hypertension, chronic kidney disease (CKD), congestive heart failure, and cerebrovascular accidents. The multivariable logistic regression model identified the CHA2DS2‐VASc score and CKD as independent predictors of NOAF following primary percutaneous coronary intervention. Furthermore, the incidence of MACCE was higher in the AF group, and AF independently predicted MACCE with a hazard ratio of 2.766.ConclusionThe CHA2DS2‐VASc score and the presence of CKD can serve as useful predictors of NOAF among patients with STEMI. Early detection and appropriate management are crucial to improve outcomes.

show abstract

Long-term prognostic outcomes and implication of oral anticoagulants in patients with new-onset atrial fibrillation following st-segment elevation myocardial infarction

Cited by 15 publications

References 27 publications

Triglyceride-Glucose Index and New-Onset Atrial Fibrillation in ST-Segment Elevation Myocardial Infarction Patients After Percutaneous Coronary Intervention

Triglyceride-Glucose Index and New-Onset Atrial Fibrillation in ST-Segment Elevation Myocardial Infarction Patients After Percutaneous Coronary Intervention

Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction

Incidence and predictors of new‐onset atrial fibrillation in ST‐elevation myocardial infarction: A single‐center study

Contact Info

Product

Resources

About