The interplay between atrial fibrillation and acute myocardial infarction

Abstract

Atrial fibrillation is the most frequently occurring supraventricular arrhythmia in patients presenting with acute myocardial infarction. It is associated with worse outcomes when it coexists with acute myocardial infarction and results in increased morbidity and mortality. Both conditions are closely related to each other and share similar pathophysiological pathways. The management of atrial fibrillation in patients with acute myocardial infarction is challenging since triple antithrombotic therapy is indicated, but this results in a markedly increased risk of bleeding events and mortality. This review addresses the interactions between both conditions including common risk factors, possible mechanisms through which acute myocardial infarction contributes to development of atrial fibrillation and vice versa, and the problem of using anticoagulation in the management of these patients.

Atrial Fibrillation With Myocardial Infarction Presenting as a Progressive Worsening Fatigue in a Young Male

“…Studies have shown that when AF occurs, there is a sustained prothrombotic and inflammatory environment through the activation of platelets, the generation of thrombin, and the induction of endothelial dysfunction, which can exponentially increase the risk for myocardial infarction [ 2 ]. This, in conjunction with intermittent episodes of tachycardia, such as seen in this patient, can induce a demand-supply mismatch and further induce myocardial infarction [ 8 ]. This creates a bidirectional relationship between myocardial infarction and AF, which can be attributed to the similar risk factors and disease pathogenesis between the two conditions [ 2 ].…”

“…Thus, these patients are less likely to be treated with appropriate antithrombotic agents. To help reduce the risk for myocardial infarctions, being able to identify the wide variety of symptoms of AF in addition to screening for AF can help physicians recognize AF early on in the disease course and initiate preventative treatment [ 8 ].…”

Effect of SWOT Analysis Combined with the Medical and Nursing Integration Emergency Nursing Process on Emergency Treatment Efficiency and Prognosis of Patients with Acute Myocardial Infarction

“…The SWOT analysis method is an analysis method that measures the internal competitive environment and competitive conditions of the organization, analyzes the advantages and disadvantages and identifies the challenges faced by the related work, and further formulates and implements the solution according to the specific analysis results, so that the related work can be effectively solved. [ 12 ]. The study believed that introducing it into nursing management could objectively and comprehensively analyze the internal and external environment of nursing organization, formulate scientific nursing countermeasures according to the constructed situation matrix, and enhance the scientificity of nursing management and the market adaptability of nursing organization [ 13 ].…”

Oral anticoagulant therapy for patients with new-onset atrial fibrillation following acute myocardial infarction: A narrative review

“…Atrial fibrillation shares a couple of risk factors with AMI, such as aging, hypertension, obesity, diabetes, alcohol consumption, and sleep-disordered breathing ( 4 , 5 , 18 ). Therefore, the two diseases may share similar pathophysiological pathways, and the co-occurrence of these two diseases seems not to be avoidable ( 4 ).…”

“…The antithrombotic therapy for AMI-NOAF patients is contradictory. For AMI, dual antiplatelet therapy (DAPT) with aspirin and a P2Y 12 inhibitor is indicated to prevent stent thrombosis, ( 17 ) while in AF patients, oral anticoagulant (OAC) therapies including vitamin K antagonists (VKAs) or non-vitamin K oral anticoagulants (NOACs) are more effective in preventing stroke and other thromboembolic events ( 18 , 19 ). However, triple therapy combining DAPT with an anticoagulant is usually associated with an increased rate of excessive bleeding, which limits the clinical application ( 20 ).…”