Trends in Atrial Fibrillation in Patients Hospitalized with an Acute Coronary Syndrome

Abstract

Background Atrial fibrillation is common among patients with cardiovascular disease and is a frequent complication of the acute coronary syndrome. Data are needed on recent trends in the magnitude, clinical features, treatment, and prognostic impact of pre-existing and new-onset atrial fibrillation in patients hospitalized with an acute coronary syndrome. Methods The study population consisted of 59,032 patients hospitalized with an acute coronary syndrome at 113 sites in the Global Registry of Acute Coronary Events Study between 2000 and 2007. Results 4,494 participants (7.6%) with acute coronary syndrome reported a history of atrial fibrillation and 3,112 (5.3%) developed new-onset atrial fibrillation during their hospitalization. Rates of new-onset atrial fibrillation (5.5% to 4.5%) and pre-existing atrial fibrillation (7.4% to 6.7%) declined during the study. Pre-existing atrial fibrillation was associated with older age and greater cardiovascular disease burden, whereas new-onset atrial fibrillation was closely related to the severity of the index acute coronary syndrome. Patients with atrial fibrillation were less likely than patients without atrial fibrillation to receive evidence-based therapies and were more likely to develop in-hospital complications, including heart failure. Overall hospital death rates in patients with new-onset and pre-existing atrial fibrillation were 14.5% and 8.9%, respectively, compared to 1.2% in those without atrial fibrillation. Short-term death rates in atrial fibrillation patients declined over the study period. Conclusions Despite a reduction in the rates of, and mortality from, atrial fibrillation, this arrhythmia exerts a significant adverse effect on survival among patients hospitalized with an acute coronary syndrome. Opportunities exist to improve the identification and treatment of acute coronary syndrome patients with, or at risk for, atrial fibrillation to reduce the incidence and resultant complications of this dysrhythmia.

Antithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome in the real world: Data from the Berlin AFibACS Registry

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Prevalence and Impact of High Platelet Reactivity in Chronic Kidney Disease

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Management and Outcomes in Acute Coronary Syndrome With Atrial Fibrillation in “Non-Invasive” Clinic

“…Похожие результаты продемон-стрированы также в более крупных исследованиях. Так, например, данные международного регистра GRACE показывают, что у пациентов с ОКС как с предсуществующей, так и с вновь возникшей ФП значительно выше госпитальная летальность (14,5% и 8,9%, соответственно), чем у пациентов без ФП (1,2%) [2]. Результаты мета-анализа исследований с ОКС показали, что риск госпитальной смерти у пациентов с ФП на ЭКГ был в 2 раза выше, чем у пациентов с синусовым ритмом (относительный риск 2,00; 95% доверительный интервал 1,93-2,08; р<0,0001) [3].…”