Prognostic significance of atrial fibrillation/atrial flutter in patients with acute myocardial infarction treated with percutaneous coronary intervention

Kinjo, Kunihiro; Sato, Hiroshi; Sato, Hideyuki; Ohnishi, Yozo; Hishida, Eiji; Nakatani, Daisaku; Mizuno, Hiroya; Fukunami, Masatake; Koretsune, Yukihiro; Takeda, Hiroshi; Hori, Masatsugu

doi:10.1016/j.amjcard.2003.07.021

Cited by 147 publications

(159 citation statements)

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“…1,15 The depressed cardiac function was probably a major reason why patients with atrial fibrillation/-flutter more often developed congestive heart failure and cardiogenic shock during hospitalization than patients without the condition, and may be part of the reason for the increased susceptibility for the development of ventricular arrhythmias. Similar association was found by Kinjo et al 7 In his study, significantly more in-hospital events (cardiogenic shock, congestive heart failure, ventricular tachycardia, and ventricular fibrillation) (P < 0.001) occurred in patients suffering from AF.…”

Section: Discussionsupporting

confidence: 74%

“…In this study, AF occurred in 12% of patients. 7 The wide-spread use of interventional coronary revascularization (PCI), especially during the acute phase, has been associated with a notable decline in the AF incidence. Not unexpectedly, trials evaluating the effects of ACE, AT II-inhibitors, or b-blockers on mortality and morbidity in patients with AMI reported the lowest incidence rates of AF in the setting of AMI but the major impact of this pharmacological therapy was upon the late development of AF.…”

Section: Introductionmentioning

confidence: 99%

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Association of comorbidities in atrial fibrillation in acute myocardial infarction

et al. 2017

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Background: Atrial fibrillation is a most common arrhythmia in patients with and without structural heart disease with an increasing incidence mainly due to the aging population. As the population ages, one can expect that AF will remain a frequent and troublesome complication of AMI with comorbidities. Therefore, the present study was undertaken to investigate the association of co-morbidities in atrial fibrillation in acute myocardial infarction.Methods: The study was performed after the institutional ethical clearance and consent from all the patients. Heart rate, atrial fibrillation, blood pressure, ventricular fibrillation and stroke after acute myocardial infarction were recorded. The blood sugar and serum lipid levels were also measured using commercially available kit as per the manufacturer’s guidelines. The data was analyzed for statistical significance using univariate analysis and comparison was performed by Fisher Exact test and by using SPSS Version 20.Results: In our study, all the patients who developed AF after AMI were more than 60 years of age. Higher heart rate was more than or equal to 100 in 62.5% of the patients. 25% of patients had diabetes mellitus 75% of 8 patients had atrial fibrillation after acute myocardial infarction, 77% of patients without atrial fibrillation were known hypertensive’s. Out of the patients who had atrial fibrillation, 50% had hyperlipidemia and developed ventricular fibrillation.Conclusions: Higher heart rate (>100 bpm) at time of presentation is a risk factor for AF following to AMI. Patients with new onset AF after AMI had more complication during hospital stay.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Association of comorbidities in atrial fibrillation in acute myocardial infarction

et al. 2017

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“…[1][2][3][4] Mortality in AMI patients with AF has also been shown to be up to twice as high as for those without AF. 1,[5][6][7] There are several trials and reviews concerning the efficacy of oral anticoagulants (OACs) in patients with AF without AMI 8 and regarding OAC in AMI without AF. 9 -12 However, there are no results available from large randomized trials or observational cohorts with regard to the efficacy of OAC in patients with both AMI and AF.…”

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confidence: 99%

Anticoagulation Therapy in Atrial Fibrillation in Combination With Acute Myocardial Infarction Influences Long-Term Outcome

2005

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for the RIKS-HIA Registry Background-The American and European guidelines do not agree with regard to antithrombotic treatment in patients with atrial fibrillation (AF) and acute myocardial infarction (AMI), thus causing uncertainty among physicians. We investigated the prescription of oral anticoagulation (OAC) in patients discharged alive with AF after an AMI and the influence of OAC treatment on 1-year mortality. Methods and Results-This was a prospective cohort study using data from the Register of Information and Knowledge about Swedish Heart Intensive care Admissions (RIKS-HIA) on patients admitted to the coronary care units of 72 Swedish hospitals from 1995 to 2002. A total of 6182 patients discharged alive with first registry-recorded AMI and AF on discharge ECG were included. One-year mortality data were obtained from the Swedish National Cause of Death Register. Only 30% (nϭ1848) of the 6182 patients with AF were prescribed OAC. At 1 year, the unadjusted mortality was 31% (1183 deaths) in the platelet-inhibitors only group and 22% (414 deaths) in the OAC-treated group. In Cox regression analysis with adjustment for confounding factors, OAC treatment was associated with a reduction in 1-year mortality (relative risk 0.73; 95% CI 0.62 to 0.86; PϽ0.001) in hospital survivors of AMI with AF. The reduction in mortality appeared to be caused primarily by a lower rate of ischemic heart death (55.6% versus 62.0%) and fatal stroke (5.7% versus 7.5%) in the OAC group. This reduction of mortality was similar among most subgroups based on age, sex, baseline characteristics, previous disease manifestations, and medications. Conclusions-In daily clinical practice, OAC was only given to a minority (30%) of AMI patients with AF, despite the fact that OAC was associated with a 29% relative and 7% absolute reduction in 1-year mortality after adjustment for confounding variables. The results emphasize the importance of OAC treatment for AF after AMI. (Circulation. 2005; 112:3225-3231.)

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“…All of these www.lipid.or.kr Atrial arrhythmia is commonly known as a risk factor and poor prognosis factor for MI. 22,23 Beukema RJ, et al…”

Section: Discussionmentioning

confidence: 99%

Long-term Clinical Outcomes in Acute Myocardial Infarction Patients with Left Ventricular Dysfunction

Jeong

Hong

et al. 2016

J Lipid Atheroscler

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Objective: The purpose of this study was to define the effect of the changes of left ventricular ejection fraction (LVEF) on long-term major adverse cardiac events (MACEs) in patients with acute myocardial infarction (AMI). Methods: Clinical analysis was performed on 1,188 AMI patients who completed follow-up 2-dimensional (2D) echocardiography after one year and clinical follow-up for 5 years. These patients were divided into three groups according to the LVEF change ratio: group A [increased LVEF change ratio, N=626], group B [decreased LVEF change ratio<20%, N=414], group C [decreased LVEF change ratio≥20%, N=148]. Results: Initial low LVEF group and normal LVEF group showed no differences in MACEs. The mean initial and follow-up LVEF were 54.4±12.2% and 60.4±12.3% in the group A, 54.6±13.0% and 47.9±12.1% in the group B, and 56.5±12.6% and 39.9±11.6% in the group C (p=0.71). Total MACEs occurred in 62 (9.9%) patients in the group A, 83 (20.0%) patients in the group B, 44 (29.7%) patients in the group C during 5-year clinical follow-up (p=0.01). Initial low EF (<45%) was not a risk factor for long-term MACEs (Odd ratio (OR), 1.686; 95% confidence index (CI), 0.861-2.862, p=0.065), but the LVEF change ratio was a strong risk factor for long-term MACEs (OR, 3.731; 95% CI, p=0.001). MACE-free survivals of patients with initial low LVEF and patients with low LVEF during follow-up period showed no significant differences (p=0.731). Conclusion: Initial low LVEF is not a predictor of long-term MACEs, but the decreased LVEF ratio during follow-up period is a strong predictor of long-term MACEs. (J Lipid Atheroscler 2016 June;5(1):37-47)

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Prognostic significance of atrial fibrillation/atrial flutter in patients with acute myocardial infarction treated with percutaneous coronary intervention

Cited by 147 publications

References 17 publications

Association of comorbidities in atrial fibrillation in acute myocardial infarction

Association of comorbidities in atrial fibrillation in acute myocardial infarction

Anticoagulation Therapy in Atrial Fibrillation in Combination With Acute Myocardial Infarction Influences Long-Term Outcome

Long-term Clinical Outcomes in Acute Myocardial Infarction Patients with Left Ventricular Dysfunction

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