Comparison of outcomes of patients with acute coronary syndromes with and without atrial fibrillation

Mehta, Rajendra H.; Dabbous, O.; Granger, Christopher B.; Kuznetsova, Polina; Kline–Rogers, Eva; Anderson, Frederick A.; Fox, Keith A.A.; Gore, Joel M.; Goldberg, Robert J.; Eagle, Kim A.

doi:10.1016/j.amjcard.2003.06.001

Cited by 144 publications

(123 citation statements)

References 14 publications

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“…Lau et al 2 recently published the results of a multicenter registry of Ͼ3000 patients, which showed that new-onset AF was an independent predictor of hospital death, not follow-up death, unlike previous FA, which was an independent predictor of long-term mortality, but not in-hospital death. These results are consistent with those reported by Mehta et al 3 with the results of the Global Registry of Acute Coronary Events. According to these authors, only newonset AF is an independent predictor of in-hospital adverse events.…”

Section: To the Editorsupporting

confidence: 93%

Letter by Raposeiras-Roubín et al Regarding Article, “Mortality Associated With Atrial Fibrillation in Patients With Myocardial Infarction: A Systematic Review and Meta-Analysis”

2011

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Section: To the Editorsupporting

confidence: 93%

Letter by Raposeiras-Roubín et al Regarding Article, “Mortality Associated With Atrial Fibrillation in Patients With Myocardial Infarction: A Systematic Review and Meta-Analysis”

2011

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“…Similar mechanisms have also been proposed to explain AF onset in the context of acute coronary syndromes, an occurrence also associated with adverse prognostic significance. 18,19 The present hypothesis has recently found support in the observation that ST-T segment abnormalities during exercise stress testing in HCM patients predict subsequent occurrence of AF, 20 suggesting that inducible ischemia does play a role in this regard. Other potential mechanisms may include more diffuse and substantial collagen metabolism abnormalities favoring atrial fibrosis and arrhythmogeneicity, and recurrent mitral regurgitation, caused by regional ischemic LV dysfunction, ultimately reflecting upon left atrium structure and function.…”

Section: Discussionsupporting

confidence: 56%

Relationship between atrial fibrillation and blunted hyperemic myocardial blood flow in patients with hypertrophic cardiomyopathy

Sciagrà

Sotgia

Olivotto

et al. 2009

Journal of Nuclear Cardiology

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Background. Atrial fibrillation (AF) and coronary microvascular dysfunction (CMD) are common in hypertrophic cardiomyopathy (HCM), but whether they are associated is unclear. We assessed the relationship between AF and CMD in HCM.Methods and Results. Global hyperemic myocardial blood flow (hMBF) was measured in 95 HCM patients (16 with, 79 without paroxysmal or chronic AF) by N-13 ammonia positron emission tomography (PET) after dipyridamole infusion. AF patients were older (50.5 ± 13.4 vs. 38.7 ± 14.9 years, P < .0005), had larger left atrial diameter (49.8 ± 7.4 vs 38.6 ± 5.7 mm, P < .00001), and left ventricular end-systolic diameter (30.4 ± 6.7 vs 25.5 ± 5.3 mm, P < .005) compared with those in stable sinus rhythm. In patients with AF, hMBF was significantly lower (1.23 ± 0.44 vs 1.87 ± 0.90 mL/min/g, P < 0.0001). In multivariate logistic regression analysis, hMBF, left atrial diameter, and age were independently associated with AF (P < .05 for all).Conclusions. HCM patients with paroxysmal or chronic AF have lower hMBF than those in stable sinus rhythm. The association between CMD and AF is independent of other known predictors of AF, suggesting a causal link between these two features. (J Nucl Cardiol 2009;16:92-6)

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“…There are persuasive data indicating that AF increases the risk of MACCE after an AMI, and ischemic stroke is one of the major complications of AF [18,19,20,21]. However, there are few reports about how the combination of CKD and AF affects the risk of MACCE in AMI patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Chronic Kidney Disease and Atrial Fibrillation on Morbidity and Mortality in Patients with Acute Myocardial Infarction

Hwang¹,

Park

Yoon³

et al. 2014

Am J Nephrol

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Background/Aims: Atrial fibrillation (AF) often coexists with acute myocardial infarction (AMI), and chronic kidney disease (CKD) is a major risk for AMI. However, the combined impact of CKD and AF on the mortality and morbidity in AMI population has not been determined. Methods: Between January 2004 and December 2009, a total of 4,738 AMI patients were enrolled prospectively. Patients were divided into four groups according to the combined status of CKD and AF. The primary endpoint was a combination of 5-year major adverse cardiac and cerebrovascular events (MACCE). Results: The prevalence of AF was significantly higher in CKD patients than in non-CKD patients (6.76 vs. 3.31%, p < 0.001). The highest cumulative event rate of MACCE and death was observed in patients with both CKD and AF (68.5 and 64.0%), respectively. In multivariable analyses, compared with patients with neither AF nor CKD, hazard ratios (HR) for composite of MACCE were 1.66 (95% CI, 1.14-2.41), 1.24 (95% CI, 1.06-1.46), and 2.10 (95% CI, 1.42-3.13) for patients with AF only, those with CKD only, and those with both CKD and AF, respectively (p for interaction = 0.935). Patients with both CKD and AF had a greatest risk for all-cause mortality (HR 2.54; 95% CI, 1.60-4.53), and the significant synergistic interaction was observed between CKD and AF (p for interaction = 0.015). Conclusion: The combined effect of AF and CKD on the risk of MACCE after an AMI is stronger than any separate condition, and it confers a synergistic effect on the all-cause mortality risk.

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Comparison of outcomes of patients with acute coronary syndromes with and without atrial fibrillation

Cited by 144 publications

References 14 publications

Letter by Raposeiras-Roubín et al Regarding Article, “Mortality Associated With Atrial Fibrillation in Patients With Myocardial Infarction: A Systematic Review and Meta-Analysis”

Letter by Raposeiras-Roubín et al Regarding Article, “Mortality Associated With Atrial Fibrillation in Patients With Myocardial Infarction: A Systematic Review and Meta-Analysis”

Relationship between atrial fibrillation and blunted hyperemic myocardial blood flow in patients with hypertrophic cardiomyopathy

Clinical Significance of Chronic Kidney Disease and Atrial Fibrillation on Morbidity and Mortality in Patients with Acute Myocardial Infarction

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