Mechanisms of new-onset atrial fibrillation complicating acute coronary syndrome

Wang, J.; Yang, Yue-Jin; Zhu, Jiabin

doi:10.1007/s00059-014-4149-3

Cited by 28 publications

(17 citation statements)

References 81 publications

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“…However, multifactorial mechanisms such as atrial ischaemia, atrial pressure overload, inflammation and neurohormonal activation are considered to be involved in the development of AF in patients with ACS. 17 Accordingly, regarding pressure overload and inflammation, patients with AF had lower LVEF and higher levels of proBNP and high-sensitive C reactive protein than patients with SR in the present study. Beta blockers may exert protective effects against AF through their anti-adrenergic and anti-ischaemic effects.…”

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confidence: 44%

New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke

et al. 2020

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ObjectiveTo investigate the long-term prognostic implications of transient new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI).DesignRetrospective observational study.SettingSingle tertiary centre.ParticipantsThis study included 2523 patients who presented with AMI from 3 June 2003 to 24 February 2015, after the exclusion of those with prior AF or in-hospital death.Outcome measuresPatients were divided into three groups according to the occurrence and type of new-onset AF: (1) sinus rhythm (SR) group; (2) paroxysmal AF (PaAF: AF converted to SR prior to discharge) group and (3) persistent AF (PeAF: AF persisted during the hospitalisation) group. Post-discharge all-cause mortality and stroke incidences were compared between the groups.ResultsNew-onset AF was observed in 271 patients (10.7%; PaAF: 230, PeAF: 41). The median follow-up period was 7.2 years (IQR: 5.2–9.4). The incidence of all-cause death and stroke was highest in the PeAF group, followed by the PaAF and SR groups (all-cause mortality: 48.8% vs 26.5% vs 14.7%, p<0.001; stroke 22.0% vs 8.3% vs 4.4%, p<0.001). In the multivariable analysis, PaAF and PeAF were associated with an increased risk of stroke (PaAF, HR: 1.972, 95% CI: 1.162–3.346; PeAF, HR: 5.160, CI: 2.242–11.873) compared with SR. The PaAF group showed a higher incidence of post-discharge AF than the SR group (29.1% vs 4.2%, p<0.001).ConclusionsNew-onset AF following AMI is associated with poor long-term outcomes. Even when AF episodes are brief and are converted to SR, new-onset AF remains associated with an increased risk of recurrent AF and stroke.

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confidence: 44%

New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke

et al. 2020

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“…One study suggested that both new-onset and history of AF shared similar adverse cardiovascular events (Biasco et al, 2018). Older age is among one of the most important predictors for new-onset AF in ACS (Gorenek et al, 2014;Schmitt et al, 2009;Wang et al, 2015). Thus, identifying risk factors of new onset AF is paramount as a first step of such primary prevention.…”

Section: Discussionmentioning

confidence: 99%

“…Others include prior MI, Killip III/IV, left atrial enlargement, and inflammation (Gorenek et al, 2014;Schmitt et al, 2009;Wang et al, 2015). Recently, Raposeiras Roubín et al (2015) found that CIN may trigger new-onset AF in patients with ACS who underwent PCI.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, identifying risk factors of new onset AF is paramount as a first step of such primary prevention. Older age is among one of the most important predictors for new-onset AF in ACS (Gorenek et al, 2014;Schmitt et al, 2009;Wang et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, newonset AF is of particular interest as it may pose higher risks of these morbidity and mortality (Zeymer et al, 2018). So far, numerous risk factors of new-onset AF have been contemplated including older age, male, higher Killip score, left atrial enlargement, and inflammation (Gorenek et al, 2014;Schmitt, Duray, Gersh, & Hohnloser, 2009;Wang, Yang, & Zhu, 2015).…”

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confidence: 99%

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Contrast‐induced nephropathy is associated with new‐onset atrial fibrillation in acute coronary syndrome after cardiac catheterization: Systemic review and meta‐analysis

Prasitlumkum

Kanitsoraphan

Kittipibul

et al. 2019

Noninvasive Electrocardiol

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Introduction Contrast‐induced nephropathy (CIN) is associated with increased cardiovascular morbidity and mortality in patients with acute coronary syndrome (ACS). Recent studies suggest that CIN is associated with new‐onset atrial fibrillation (AF) in patients with acute coronary syndrome (ACS) who underwent catheterization. However, a systematic review and meta‐analysis of the literature have not been done. We assessed the association between CIN in patients with ACS and new‐onset AF by a systematic review of the literature and a meta‐analysis. Hypothesis CIN is associated with new‐onset AF in patients with ACS. Methods We comprehensively searched the databases of MEDLINE and EMBASE from inception to April 2018. Included studies were published cohort studies that compared new‐onset AF after cardiac catheterization in ACS patient with CIN versus without CIN. Data from each study were combined using the random effects, generic inverse variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals. Results Five studies from December 2009 to February 2018 were included in this meta‐analysis involving 5,640 subjects with ACS (1,102 with CIN and 4,538 without CIN). Contrast‐induced nephropathy significantly correlates with new‐onset AF after cardiac catheterization (pooled risk ratio = 2.84, 95% confidence interval: 1.66–4.87, p < 0.001, I2 = 58%) Conclusions Contrast‐induced nephropathy is associated with new‐onset AF threefold among patients with ACS after cardiac catheterization. Our study warranted further study to establish the causality between CIN and new‐onset AF.

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Predictors of new-onset atrial fibrillation in elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention

et al. 2018

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Mechanisms of new-onset atrial fibrillation complicating acute coronary syndrome

Cited by 28 publications

References 81 publications

New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke

New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke

Contrast‐induced nephropathy is associated with new‐onset atrial fibrillation in acute coronary syndrome after cardiac catheterization: Systemic review and meta‐analysis

Predictors of new-onset atrial fibrillation in elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention

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