Bidirectional Association Between Atrial Fibrillation and Myocardial Infarction, and Relation to Mortality in the Framingham Heart Study.

Autor: Frederiksen TC; Department of Cardiology Aarhus University Hospital Aarhus Denmark.; Department of Clinical Medicine, Health Aarhus University Aarhus Denmark., Benjamin EJ; Department of Epidemiology Boston University School of Public Health Boston MA.; Section of Cardiovascular Medicine Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine Boston MA.; National Heart, Lung, and Blood Institute and Boston University's FHS (Framingham Heart Study) Framingham MA., Trinquart L; Institute for Clinical Research and Health Policy Studies Tufts Medical Center Boston MA.; Tufts Clinical and Translational Science Institute Tufts University Boston MA., Lin H; Department of Medicine University of Massachusetts Chan Medical School Worcester MA., Dahm CC; Department of Public Health Aarhus University Aarhus Denmark., Christiansen MK; Department of Cardiology Viborg Regional Hospital Viborg Denmark., Jensen HK; Department of Cardiology Aarhus University Hospital Aarhus Denmark.; Department of Clinical Medicine, Health Aarhus University Aarhus Denmark., Preis SR; National Heart, Lung, and Blood Institute and Boston University's FHS (Framingham Heart Study) Framingham MA.; Department of Biostatistics Boston University School of Public Health Boston MA., Kornej J; Section of Cardiovascular Medicine Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine Boston MA.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 Jun 04; Vol. 13 (11), pp. e032226. Date of Electronic Publication: 2024 May 23.
DOI: 10.1161/JAHA.123.032226
Abstrakt: Background: Individuals with both atrial fibrillation (AF) and myocardial infarction (MI) have higher mortality compared with individuals with only 1 condition. Whether mortality differs according to the temporal order of AF and MI is unclear.
Methods and Results: We included participants from the FHS (Framingham Heart Study) from 1960 and onwards. We assessed the hazard ratio (HR) of new-onset AF and MI, and mortality according to MI and AF status (prevalent and interim) using multivariable-adjusted Cox proportional hazards models. Interim diseases were modeled as time-varying variables. For the analysis of new-onset AF, 10 923 participants (55% women; mean±SD age, 54±8 years) were included. For new-onset MI, 10 804 participants (55% women; mean±SD age, 54±8 years) were included. Compared with no MI, the hazard of new-onset AF was higher in participants with prevalent (HR, 1.60 [95% CI, 1.32-1.94]) and interim MI (HR, 3.96 [95% CI, 3.18-4.91]). Both ST-segment-elevation MI and non-ST-segment-elevation MI were associated with new-onset AF. Interim AF, not prevalent AF, was associated with higher hazard rate of new-onset MI (HR, 2.21 [95% CI, 1.67-2.92]). Interim AF was associated with both ST-segment-elevation MI and non-ST-segment-elevation MI. Mortality was significantly greater among participants with AF and MI compared with participants with 1 of the 2, regardless of temporal order.
Conclusions: We report a bidirectional association between AF and MI, which was observed for both non-ST-segment-elevation MI and ST-segment-elevation MI. Participants with both AF and MI had considerably higher mortality compared with participants with only 1 of the 2 conditions, regardless of order.
Databáze: MEDLINE
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